Metastatic Bone Disease

Metastatic bone disease is a secondary cancer that has spread or metastasized to the bone from the other cancerous organs. The cancers that metastasize to bones include the cancers of lungs, breast, thyroid, kidney and prostate.

Metastatic bone disease causes weakness of the bones, make them brittle and break easily. The impact of the disease on the quality of life depends on the extent of spread, the type and number of bones involved and the severity of damage to each bone. It mostly affects upper arm, long bone of the leg, pelvis, spine, ribs and skull.

The symptoms of the metastatic bone disease are not very specific and may also indicate other bone disorders. Therefore appropriate diagnosis is very important. Your oncologist will collect detailed medical and family history and will examine the areas having pain. Some of the tests that help in diagnosing metastatic bone disease include:

• X-rays: X-ray of the area beyond the pain site may be asked because sometimes the source of pain and the site of pain may differ. X-ray images give enough information about the extent of bone involved.
• Bone scan: Bone scan may be ordered to assess which all the bones of body are affected. Bone scan is done by injecting a radioactive substance before scan. This material binds more to the diseased bone which appear as darker areas in the scan as compared to the normal bones. Bone infection, previously fractured bones and arthritic bones also appear darker but the pattern differs from that of bone metastases.
• Computed tomography (CT scan) and magnetic resonance imaging scans: These scans provide more detailed information and are often ordered if spine or hip joint is affected.

The best possible approach of managing metastatic bone disease is to treat the primary cancer. Chemotherapy, radiation therapy or appropriate surgical treatment will be given for the primary cancer.

The treatment goals of metastatic bone disease include reducing pain and retarding or avoiding the spread of disease.

• Pain medicine: To reduce the pain nonsteroidal anti-inflammatory agents are prescribed.
• Chemotherapy: Chemotherapy for cancer is administering anti-cancer drugs that destroy the cancer cells. Most of these chemotherapeutic agents also affect normal cells of the body and cause side effects such as nausea, hair fall and decrease the immunity.
• Radiation therapy: Radiation therapy may be used alone or along with other cancer therapies which depends on the site and severity of cancer. It uses high-energy ionizing radiation to kill the tumor cells.

Additional orthopedic surgeries may be performed to stabilize or repair the affected bones by metal screws and plates. Surgery is done in certain cases to remove tumor, reduce pain, and prevent or repair the damaged bones by supporting them with wires, rods, pins, plates and screws. Bone cement may also be used to fill the big lesions in the bone.