Honestly I think part of the issue with bone mets is that the standard is *not* to treat them unless they are symptomatic. They can't resect them conventionally, but there are devices that can ablate them and then they can fill the hole with bone cement, but this seems to be rarely done. Even when they use radiation, they don't try to kill them, just "manage" them. I understand that there are risks but they just assume there is no benefit to destroying the met in most cases.
My husband has a single met and it's very small and anterior in the vertebra, so away from the cord, so it seems it would be fairly low risk to destroy it but I doubt that would be considered.
D/H Dx 10/2019 RC age 61
Clinical T4bN2M1a (common iliac and para-aortic lymph nodes)
MSS KRAS G12D
CRT 11/19-1/20 FOLFOX 3/20-7/20
Pelvic exenteration w/LAR 8/20
ypT4bN0Mx G3 0/14 nodes LVI not seen PNI-
CEA 10/19:20, 1/20-11/20:1.6, 4.3, 3.4, 2.7, 2/21:9.0 3/21:18,40 4/21:28,19, 5/21:13.3,8.6
PET 3/21 recurrence in distal nodes, L5 vertebra, pelvis