Bone metastases are cancerous tumors in the bone that have spread from another part of the body. The word for 1 of these tumors is “metastasis.” Doctors sometimes also use the term “bone lesion” to describe an abnormal spot in the bone. When bone metastases happen, they most commonly affect the spine, pelvis, and thigh bone (femur).
Any type of cancer can spread to the bones. But it is more common with certain types, including:
●Multiple myeloma – This is a cancer of a certain type of white blood cell. White blood cells are made in the center of your bones, in a part called the bone marrow.
What are the symptoms of bone metastases? Many times, bone metastases cause few or no symptoms. When they do cause symptoms, they can include:
●Pain – This is the most common symptom. The type of pain depends on where the metastases are and how big they are. Pain can be achy, sharp, burning, or shooting. It might be there all the time, or it might only happen when you move that part of your body.
●Nerve-related symptoms – If metastases are in the spine, this can put pressure on the spinal cord. When this happens, it can cause nerve symptoms. These can include weakness, trouble moving or feeling part of the body, or trouble controlling the bladder or bowels.
Bone metastases make the bones weaker than normal. As a result, they can fracture or break more easily. Fractures cause pain. They also sometimes cause bruising or swelling in the area.
Is there a test for bone metastases? Yes. Your doctor or nurse can order an imaging test to check for bone metastases. Imaging tests create pictures of the inside of the body. They include X-rays, CT scans, MRI scans, and PET scans.
Another test that is sometimes done is a bone biopsy. For a bone biopsy, a doctor uses a needle to take a small sample of tissue from the spot that looks abnormal. Then the sample is examined under a microscope.
How are bone metastases treated? Treatment depends on many factors, such as:
●The type of cancer you have, and how far it has spread in your body
●Your overall health
●Your prognosis – This is the term doctors use to describe how long they expect you to live.
The main goals of treatment are to relieve pain, improve movement, and lower the risk of fractures. In most cases, treatment cannot cure bone metastases, and eventually they will continue to grow and spread over time. But there are many cancer treatments that might slow the growth and spread. There are also other treatments that can reduce symptoms and lower the chances of other problems.
Treatment might include 1 or more of the following:
●Pain medicines – Over-the-counter pain medicines can be used to treat mild pain. These include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin) and naproxen (brand name: Aleve). But most people need stronger prescription pain medicines.
●Medicines to make the bones stronger – These medicines can lower the risk of fractures. They might also provide some pain relief.
●Radiation therapy – Radiation kills cancer cells. Doctors use radiation in different ways to treat bone metastases.
●Medicines to treat your cancer – Depending on the type of cancer you have, you might get different medicines. Medicines can be used to treat cancer anywhere in the body, including the bone metastases. This might involve chemotherapy, hormone treatment, immunotherapy, or other medicines.
●Surgery – You might need surgery if you have a fracture or a bone that is likely to break. You might also need surgery if you have metastases on your spine that are pushing against your spinal cord.
●Ablation therapy – If other treatments do not help, your doctor might suggest something called ablation therapy. This is a treatment that kills cancer cells. It can do this using heat (“radiofrequency ablation”) or cold (“cryoablation”). There is also a treatment called “focused ultrasound” that uses sound waves to create heat and destroy cells.
What else should I do? It’s important to follow all of your doctor’s instructions about visits and tests. It’s also important to talk to your doctor about any side effects or problems you have during treatment.
Getting treated for bone metastases involves making many choices, such as what treatment to have. Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
●What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
●What are the downsides to this treatment?
●Are there other options besides this treatment?
●What happens if I do not have this treatment?