The patient in question has Stage IV lung cancer and has received RT to the spine for his metastatic disease. Mostly that should take care of the pain. For insomnia treatment can be given provided there is no other over riding factor or contraindication for such treatment. There is no mention of side effects of RT that the patient developed. Insomnia is not likely to be RT related. It might be more because of anxiety related factors. It is also worthwhile trying some chemotherapy and bisphosphonates (for bone pains) if thought worthwhile by the treating oncologist.