Bone metastases

Description

Bone metastasis occurs when cancer cells spread from their original site to a bone.

Almost all types of cancer can spread (metastasize) to the bones. But some types of cancer are particularly likely to spread to bone, including breast cancer and prostate cancer.

Bone metastasis can occur in any bone but more commonly occurs in the spine, pelvis, and thigh. Bone metastasis may be the first sign that you have cancer, or bone metastasis may occur years after cancer treatment.

Bone metastases can cause pain and broken bones. With rare exceptions, the cancer that has spread to the bones you can't heal. Treatments can help reduce pain and other symptoms of the metastasis in the bones.

Symptoms

Sometimes, bone metastasis produces no signs and symptoms.

When it occurs, the signs and symptoms of bone metastasis include:

  • Pain in the bones
  • Broken bones
  • Urinary incontinence
  • The bowel incontinence.
  • Weakness in the legs or arms
  • High levels of calcium in the blood (hypercalcemia), which can cause nausea, vomiting, constipation, and confusion

When to see a doctor

If you experience persistent signs and symptoms that worry you, make an appointment with your doctor.

If you've been treated for cancer in the past, tell your doctor about your medical history and that you're concerned about your signs and symptoms.

Causes

Bone metastasis occurs when cancer cells break away from the original tumor and spread to the bones, where they begin to multiply.

The doctors are not sure what causes some types of cancer to spread. And it is not clear why some types of cancer of the trip to the bones in place of other common sites of metastasis, such as the liver.

Risk factors

Virtually any type of cancer can spread to the bones, but the cancers most likely to cause bone metastasis include:

  • Breast cancer
  • Kidney cancer
  • Lung cancer
  • Lymphoma
  • Multiple myeloma
  • Prostate cancer
  • Thyroid cancer

Bone metastases

Diagnosis

Imaging tests are used to investigate the signs and symptoms that may indicate that the metastasis in the bones. The tests you should have depend on your specific situation.

Tests may include:

  • X-ray
  • Bone scintigraphy (bone scan)
  • The computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)
  • Biopsy

Treatment

The common treatments for bone metastasis include medications, radiation therapy, and surgery. What treatments are best for you will depend on the specifics of your situation.

Drugs

The drugs used in people with bone metastases include:

  • The construction of the bones of the drug.The medications commonly used to treat people with thinning of the bones (osteoporosis) may also help people with bone metastases. These medicines can strengthen bones and reduce the pain caused by bone metastasis, by reducing the need for strong pain medications. The bone-building medications can also reduce your risk of new bone metastases. These drugs can be administered every few weeks through a vein in your arm or through an injection. The oral forms of these medications are available, but usually are not as effective as the IV or injectable forms, and can cause the digestive tract of the side effects. The construction of the bones of the medication may temporarily cause bone pain and kidney problems. That increase the risk of a rare but serious deterioration of your jaw (osteonecrosis).
  • Iv radiation.For people with multiple bone metastases, a form of radiation called radiopharmaceuticals can be given through a vein. Radiopharmaceuticals use of low levels of radioactive material that has a strong attraction to the bones. Once in your body, the particles are moved to the areas of bone metastases and their release of radiation. Radiopharmaceuticals can help control the pain caused by bone metastasis. The side effects can include damage to the bone marrow, which can lead to low blood cell counts.
  • Chemotherapy. If the cancer has spread to multiple bones, your doctor may recommend chemotherapy. Chemotherapy travels throughout the body to fight cancer cells. Chemotherapy may be taken as a pill, which is administered through a vein, or both. The side effects depend on the specific chemotherapy drugs is given. For cancers that are sensitive to chemotherapy, chemotherapy may be the best way to relieve the pain of bone metastases.
  • The hormone therapy.For cancers that are sensitive to hormones in the body, the treatment is to suppress the hormones may be an option. Cancers of the breast, and prostate cancers are often sensitive to the hormone-blocking treatments. Hormone therapy may involve taking medications to lower levels of natural hormones, or drugs that block the interaction between hormones and cancer cells. Another option is surgery to remove hormone-producing organs — the ovaries and testes.
  • Medications for pain.Pain medication can control the pain caused by bone metastasis. Pain medications may include over-the-counter pain relievers more powerful prescription pain relievers. It may take time to determine what combination of medications for pain that works best for you. If you are taking medications, but are still experiencing pain, tell your doctor. A pain specialist may be able to offer additional to relieve the pain of the options.
  • Steroids.The drugs known as steroids can often help relieve the pain associated with bone metastasis by decreasing the swelling and inflammation around the site of cancer. These steroids are different types of steroids that bodybuilders or athletes use to build muscle. Steroids can work quite quickly to help with pain and prevent some complications of the cancer, but also must be used with great caution because they have side effects, especially when used for long periods.
  • The targeted therapy.Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Certain types of cancer may respond very well to these treatments. For example, breast cancer cells that are HER2-positive may respond to certain drugs.

The construction of the bones of the drug. The medications commonly used to treat people with thinning of the bones (osteoporosis) may also help people with bone metastases. These medicines can strengthen bones and reduce the pain caused by bone metastasis, by reducing the need for strong pain medications. The bone-building medications can also reduce your risk of new bone metastases.

These drugs can be administered every few weeks through a vein in your arm or through an injection. The oral forms of these medications are available, but usually are not as effective as the IV or injectable forms, and can cause the digestive tract of the side effects.

The construction of the bones of the medication may temporarily cause bone pain and kidney problems. That increase the risk of a rare but serious deterioration of your jaw (osteonecrosis).

Iv radiation. For people with multiple bone metastases, a form of radiation called radiopharmaceuticals can be given through a vein. Radiopharmaceuticals use of low levels of radioactive material that has a strong attraction to the bones. Once in your body, the particles are moved to the areas of bone metastases and their release of radiation.

Radiopharmaceuticals can help control the pain caused by bone metastasis. The side effects can include damage to the bone marrow, which can lead to low blood cell counts.

The hormone therapy. For cancers that are sensitive to hormones in the body, the treatment is to suppress the hormones may be an option. Cancers of the breast, and prostate cancers are often sensitive to the hormone-blocking treatments.

Hormone therapy may involve taking medications to lower levels of natural hormones, or drugs that block the interaction between hormones and cancer cells. Another option is surgery to remove hormone-producing organs — the ovaries and testes.

Medications for pain. Pain medication can control the pain caused by bone metastasis. Pain medications may include over-the-counter pain relievers more powerful prescription pain relievers.

It may take time to determine what combination of medications for pain that works best for you. If you are taking medications, but are still experiencing pain, tell your doctor. A pain specialist may be able to offer additional to relieve the pain of the options.

Steroids. The drugs known as steroids can often help relieve the pain associated with bone metastasis by decreasing the swelling and inflammation around the site of cancer. These steroids are different types of steroids that bodybuilders or athletes use to build muscle.

Steroids can work quite quickly to help with pain and prevent some complications of the cancer, but also must be used with great caution because they have side effects, especially when used for long periods.

The targeted therapy. Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die.

Certain types of cancer may respond very well to these treatments. For example, breast cancer cells that are HER2-positive may respond to certain drugs.

External beam radiation therapy

Radiation therapy uses high-powered energy beams, such as X-rays and protons, to kill cancer cells. Radiation therapy may be an option if your bone metastasis is causing pain that is not controlled with medication for the pain or if the pain is limited to a small number of areas.

Depending on your situation, the radiation, the bone can be administered in a single large dose or in multiple smaller doses over a period of many days. Side effects of radiation therapy depend on the site to try and your size.

Surgery

Surgical procedures may help to stabilize a bone that is at risk of breakage or repair of a broken bone.

  • Surgery to stabilize the bone. If the bone is in danger of breaking due to bone metastases, surgeons can stabilize the bone with metal plates, screws and nails (orthopedic fixation). Orthopedic fixation can relieve pain and improve function. Often, radiation therapy is given when you have been healed after the surgery.
  • The surgery for the injection of a bone cement. The bones and cannot be easily reinforced with metal plates or screws, such as the bones of the pelvis and the bones of the spine may benefit from bone cement. Doctors inject bone cement into the bone that is broken or damaged by bone metastasis. This procedure can reduce pain.
  • The surgery to repair a broken bone.If bone metastases has caused the breaking of a bone, surgeons can work to repair the bone. This involves the use of metal plates, screws and studs to stabilize the bone. The replacement of the joint, such as a hip replacement, there may be another option. In general, bone fractures caused by bone metastasis are not helped by the placement of a cast on the broken bone.

The surgery to repair a broken bone. If bone metastases has caused the breaking of a bone, surgeons can work to repair the bone. This involves the use of metal plates, screws and studs to stabilize the bone.

The replacement of the joint, such as a hip replacement, there may be another option. In general, bone fractures caused by bone metastasis are not helped by the placement of a cast on the broken bone.

The heating and freezing of cancer cells

Procedures to kill the cancer cells with heat or cold may help control the pain. These procedures may be an option if you have one or two areas of bone metastases, and are not helped by other treatments.

During a procedure called radiofrequency ablation, a needle that contains an electric probe is inserted into the bone of the tumor. The electricity passes through the tube and heats the surrounding tissue. The tissue is allowed to cool, and the process is repeated.

A similar procedure called cryoablation freezes the tumor, and then allowing it to thaw. The process is repeated several times.

The side effects can include damage to nearby structures, such as nerves, and damage to the bones, which can increase the risk of a bone fracture.

Clinical trials

Clinical trials are studies of new treatments and new ways of using existing treatments. Enroll in a clinical trial gives you the opportunity to test the latest treatments. But a cure is not guaranteed, and the side effects of new treatments may not be known. Discuss the available clinical trials with their physician.

Physical therapy

A physical therapist can work with you to design a plan that will help you increase your strength and improve your mobility. A physical therapist may suggest assistive devices to help you cope. Some examples could include using crutches or a walker to keep weight to a bone affected by walking, a walking stick, to improve balance, or a brace to stabilize the spine.

A physical therapist may also suggest specific exercises to help maintain your strength and reduce pain.

Coping and support

Coping with bone metastasis requires more than bear the pain of bones. It also involves coming to terms with the news that his cancer has spread beyond its original site.

Cancer that has metastasized can be very difficult to cure, although people can live for several years with metastases in the bones. Your doctor will work to minimize the pain and maintain its function so that you can continue with your daily activities.

Each person finds their own way of dealing with a cancer diagnosis. Until you find what works best for you, consider trying to:

  • To find out enough about the bone metastasis to make decisions about your care. Ask your doctor about the details of your cancer and your treatment options. Ask about trusted sources of more information. If you do the research on your own, a good place to start to include the National Cancer Institute and the American Cancer Society.
  • Find someone to talk to. Although friends and family can be your best allies, in some cases, they may have difficulty coping with the shock of his diagnosis. In these cases, talk with a counselor, medical social worker, or a pastoral or religious counselor may be helpful. Ask your doctor for a referral.
  • Connect with other cancer survivors. You may find comfort in talking with other cancer survivors. Cancer survivors can provide a single view of your situation. Contact your local chapter of the American Cancer Society to find cancer support groups in your area.
  • Come to terms with his illness.Come to terms with the fact that your cancer may not be curable, it can be difficult. For some people, having a strong faith or a sense of something greater than themselves makes this process easier. Others seek the advice of someone who understands life-threatening diseases, such as a medical social worker, psychologist or chaplain. Many people also take steps to ensure that the end-of-life wishes are known and respected your wishes in writing, and discussing them with your loved ones.

Come to terms with his illness. Come to terms with the fact that your cancer may not be curable, it can be difficult. For some people, having a strong faith or a sense of something greater than themselves makes this process easier.

Others seek the advice of someone who understands life-threatening diseases, such as a medical social worker, psychologist or chaplain. Many people also take steps to ensure that the end-of-life wishes are known and respected your wishes in writing, and discussing them with your loved ones.

Preparing for your appointment

Start by making an appointment with your primary care doctor if you have signs or symptoms that worry you. Tell your doctor if you have been treated for cancer in the past, even if you have received treatment for cancer many years ago. If you are diagnosed with bone metastases, you will be referred to a cancer specialist (oncologist).

Because appointments can be brief, it is a good idea to be well prepared. Here's some information to help you to be prepared and know what to expect from your doctor.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. Take note of how much time you have been experiencing symptoms and what makes the symptoms better or worse.
  • Write down key personal information, including any major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking.
  • Consider the possibility of a family member or friend. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write questions to ask their doctor.

Prepare a list of questions can help you make the most of your time with your doctor. For bone metastases, some basic questions to ask your doctor include:

  • What is the most likely cause of my symptoms?
  • There are other possible causes of the symptoms?
  • What kinds of tests do I need?
  • What treatments are available, and which do you recommend?
  • What is my prognosis?
  • There are treatments that are experimental or clinical trials available to me?
  • I have these other health conditions. How are they going to affect my treatment?
  • Is there a generic alternative to the medicine you're prescribing me?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?
  • What is going to determine whether I should plan for a follow-up visit?

In addition to the questions that you've prepared to ask your doctor, do not hesitate to ask any additional questions that occur during your appointment.

What to expect from your doctor

Your doctor may ask you a series of questions. Be ready to answer them may allow time later to cover other points you want to address. Your doctor may ask:

  • When did you first begin experiencing symptoms?
  • The symptoms been continuous or come and go?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • Does anything make your symptoms worse?
Symptoms and treatment of Bone metastases