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Bone metastases

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Overview of bone metastasis

A cancer that begins anywhere in the body and goes on to affect the bones is called Bone metastases or metastatic bone disease (MBD). Bone metastases generally form a solid mass inside the bone and causes severe pain, with chronic aches and sporadic intense pain.


Symptoms of bone metastasis

Signs of bone metastasis include:

  • Bone pain
  • Broken bones
  • Involuntary urination
  • Involuntary defecation
  • Weakness in the legs
  • Fatigue
  • High levels of calcium in the blood


Causes of bone metastasis

It is unclear why cancer cells attack the bone and prefer to lodge itself in it. Bone metastases is not a disease in itself and is caused when cancer cells from primary source breaks, travels through the bloodstream and causes new tumors in the bones.

It is often seen that cancers of breast, kidney, lung and prostate go on to cause bone metastases. Bone metastases also prefer to affect parts of the body like the limbs, pelvis, rib cage, skull, spine and cause a lot of problems. In terms of damage a bone metastases can create holes in the bones called osteolytic lesions making them weak and brittle. On the other hand it may also spur abnormal bone build up called osteoblastic lesions.


Risk factors for bone metastasis

The risk of having bone metastases only start when you have any type of cancer. Researchers are still unsure about why some people with cancer have bone metastases and some do not. However, it can be told that certain type of cancer like breast, prostate, lung, thyroid, and kidney are more likely to spread to bones than others. 


Diagnosis of bone metastasis

To start diagnosis a doctor would generally like to go through the medical history of the patient. This would include the symptoms, track record of illnesses in the past and current health conditions. On satisfying himself, a doctor may ask a patient to undergo the following tests:  

Imaging Tests

An X – ray can clearly depict the status of bones and provides a good picture on the conditions of bones. An x-ray will help the doctor determine the stage of the disease and the affect it has had on the bone.  

Similarly other imaging tests like computerized tomography (CT) scan and magnetic resonance image (MRI) are helpful in diagnosing bone metastases and the bone or bones involved in the disease.

Bone metastases are not the same as bone cancer and tests and diagnosis should only be conducted when the patient is known to have any other form of cancer or cancer that is known to metastases. Cancer patients should also be evaluated with certain blood tests or a Positron emission tomography scan (PET scan) to diagnose bone metastases. A sample of bone marrow can also be obtained through a biopsy to determine bone metastases. This procedure can also help determine the stage of the problem and its spread.


Treatment for bone metastasis

Treatment for bone metastases can be both non-surgical and surgical. Nor-surgical methods will include: 


Chemotherapy or chemo as it is commonly known as, relies on chemicals being introduced in the body to kill the cancer cells. Chemo can be injected, swallowed orally to treat cases of bone metastases. Chemo is one of the main stay of cancer treatment and is known to be effective but cause considerable side effects. It is often used together with other methods of treatment to get better results.

Endocrine therapy

Endocrine therapy is mostly used to treat breast cancer and hence is effective when bone metastasis is cause due to breast cancer cells. Endocrine therapy is prescribed differently for women, depending on whether they are premenopausal or postmenopausal but is known to alter the properties of hormones in the body. In endocrine therapy the hormones are altered in such a way that it starts destroying cells in the body. 


This is a class of drug which limits the damage to the bones by the cancer cells. These drugs help prevent fractures, limit pain and primarily slow down the damage caused by the cancer cells. These drugs, however, have some side effects like nausea and vomiting.

Surgical methods:

Surgical procedures are often used to fix a broken bone or to prevent it from snapping and also involved removing the cancerous tumor. Different types of surgery include one that stabilizes the bone using metal plates, screws and nails (orthopedic fixation). 

Sometimes a surgery is conducted to inject a bone with cement. Bones that cannot be fixed through the orthopedic way is fixed by injecting bone cement.


Prevention of bone metastasis

The best way to prevent bone metastases from happening is to prevent a primary case of cancer from developing and detecting cases of cancer early.

Written by: Healthplus24 team
Date last updated: August 14, 2013

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