Bone metastasis happens when cancer cells break away from where they started and spread to a bone.
Metastasis is the medical term for disease that spreads to an area away from where it started. When cancer spreads, healthcare professionals say it metastasizes or is metastatic. When cancer cells spread to one spot in a bone, it's called bone metastasis. When there is more than one area of metastasis in the bones, it's called bone metastases.
Nearly all types of cancer can spread to the bones. But some types of cancer are more likely to spread to bone. These include breast cancer and prostate cancer.
Bone metastasis can happen in any bone. But it more often happens in the spine, pelvis and thigh bones. Bone metastasis may be the first sign that you have cancer. Or bone metastasis may happen years after cancer treatment.
Bone metastasis can cause pain and bones that break easily. It's rare that cancer that has spread to the bones can be cured. Treatments can help reduce pain and other symptoms of bone metastases.
Sometimes bone metastasis causes no signs or symptoms.
When they happen, symptoms of bone metastasis may include:
If bone metastasis is in the spine, it can cause:
If you have long-lasting symptoms that worry you, make an appointment with a doctor or other healthcare professional. If you've been treated for cancer in the past, tell your healthcare team about your medical history and your concern about your symptoms.
Bone metastasis is caused by cancer that starts in one area and spreads to a bone. It's not clear why some cancers travel to the bones rather than to other common sites for metastasis, such as the liver.
Some types of cancer have a higher risk of causing bone metastasis than others do. Cancers more likely to spread to the bones include:
To diagnose bone metastasis, your healthcare professional may suggest imaging tests. Tests may include:
To confirm the diagnosis, your healthcare professional might suggest a biopsy. A biopsy is a procedure to remove a sample of tissue for testing in a lab.
Common treatments for bone metastasis include medicines, radiation therapy and surgery. Your healthcare team selects the treatments that are best for you based on your situation.
Bone-building medicines help strengthen the bones. They're often used to treat thinning bones, a condition called osteoporosis. Bone-building medicines also help treat bone metastasis.
Bone-building medicines can strengthen the bones and reduce the pain caused by bone metastasis. This lowers the need for strong pain medicines. Bone-building medicines also may lower the risk of getting new bone metastasis.
Bone-building medicines are given every few weeks through a vein in the arm or through a shot. These kinds of medicines also come in pill form, but this form of the medicines may not work as well for bone metastasis.
Bone-building medicines can cause kidney problems and short-term bone pain. They also increase the risk of a rare but serious jawbone condition called osteonecrosis.
Radiopharmaceuticals are medicines that contain a low level of radioactive material. These medicines are given through a vein. Once in the body, the medicines travel to the cancer in the bones and deliver the radiation. For bone metastasis, these medicines may help relieve bone pain. Radiopharmaceutical medicines that target the bones might be an option when there is more than one bone metastasis.
Side effects can include damage to the bone marrow. This can lead to low blood cell counts.
Chemotherapy treats cancer with strong medicines. If cancer has spread to more than one bone, your healthcare professional may suggest chemotherapy.
Hormone therapy for cancer blocks certain hormones in the body. Some cancers use the body's hormones to help them grow. For these cancers, hormone-blocking treatments may help control the cancer. Breast cancers and prostate cancers often are sensitive to hormone-blocking treatments.
Hormone therapy can involve taking medicines to lower hormone levels or medicines that block the action between hormones and cancer cells. Another choice is surgery to remove organs that make the hormones that cancer cells use. These organs include the ovaries and the testes.
Pain medicines work to control the pain bone metastasis causes. You might take pain relievers you can get without a prescription or stronger prescription pain relievers.
It may take time to find the mix of pain medicines that works best for you. If you take pain medicines but still have pain, tell your healthcare professional. A pain specialist may be able to offer more choices for pain relief.
Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die.
Your cancer cells may be tested to see if targeted therapy is likely to work for you. Side effects of targeted therapy medicines depend on which medicine you receive.
Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources.
Radiation therapy can treat one or a few areas of bone metastasis. But it typically isn't used if there are many areas. Radiation can't rebuild bone weakened by cancer. But it can help ease pain and control the growth of the bone metastasis.
Radiation to the bone can be given in one treatment or several treatments over many days. Side effects of radiation depend on the site being treated and its size.
Stereotactic body radiotherapy is a highly precise, intense radiation treatment. This treatment aims beams of radiation from many angles at the cancer. Stereotactic body radiotherapy most often is done in one or a few treatments.
This treatment might be used for bone metastasis in the spine bones. It allows healthcare professionals to target the treatment to the cancer without hurting the spinal cord.
Surgical procedures can help a bone that is at risk of breaking or repair a broken bone. Operations used for bone metastasis include:
Surgery to repair a broken bone. If bone metastasis causes a bone to break, surgeons may work to repair the bone. This may involve using metal plates, screws and nails to make the bone stable. Joint replacement, such as a hip replacement, may be another choice. Most often, putting a cast on a bone broken by bone metastasis doesn't help.
Ablation therapy procedures apply treatment directly to the cancer cells. These procedures include treatments that use heat or cold to kill cancer cells. Ablation therapy may help control pain caused by bone metastasis. It may be a choice if you have one or two areas of bone metastasis that other treatments haven't helped.
During an ablation therapy procedure called radiofrequency ablation, a needle with an electric probe is put into the cancer. Electricity passes through the probe and heats the tissue around it. After the tissue cools, the process is done again.
An ablation therapy procedure called cryoablation freezes the cancer and then lets it thaw. After the tissue thaws, the process is done again.
Side effects can include damage to nearby structures, such as nerves, and damage to bones that can increase the risk of a broken bone.
Clinical trials are studies of new treatments and new ways of using existing treatments. Taking part in a clinical trial gives you the chance to try the latest treatments. But a cure isn't guaranteed. The side effects of new treatments may not be known. Ask your healthcare professional whether clinical trials may be an option for you.
A physical therapist can work with you to make a plan that will help you get stronger and move better. A physical therapist may suggest assistive devices to help you cope. Examples might include crutches or a walker to take weight off a bone while walking, a cane to improve balance, or a brace to keep the spine stable.
A physical therapist also may suggest exercises to help you keep your strength up and reduce your pain.
Coping with bone metastasis involves more than coping with bone pain. It also involves coming to terms with the news that your cancer has spread.
Treatments for bone metastasis can slow the growth of the cancer and may extend your life. But cancer that spreads can be hard to cure. Your healthcare team will work to ease your pain and keep you comfortable so that you can focus on what's important to you.
People find their own way to cope with a cancer diagnosis. Until you find what works best for you, here are some things you can try.
Find out enough about bone metastasis to help decide about your care
Ask your healthcare team about the details of your cancer and your treatment choices. Ask about where you can get more information. Good places to start are the U.S. National Cancer Institute and the American Cancer Society.
Find someone to talk with
A close friend or family member who is a good listener might be a good person to talk with about any fears or worries. Sometimes friends and family members may have trouble coping with your diagnosis, so you might choose to talk with a professional. Talking with a counselor, medical social worker, or a pastoral or religious counselor can be helpful.
Connect with other cancer survivors
You may find comfort in talking with other people who have cancer. Contact your local chapter of the American Cancer Society to find cancer support groups in your area.
Work towards accepting your diagnosis
It can be hard to accept that your cancer may not have a cure. For some people, having a strong faith or a sense of something greater than themselves makes this process easier.
Others want to talk with someone who knows about life-threatening illnesses. This could be a medical social worker, a psychologist or a chaplain.
Make end-of-life choices
Some people find comfort in planning ahead for difficult times. You may choose to review your end-of-life wishes with your healthcare professional. Write down your wishes and share them with your loved ones.
Think about hospice care
If cancer therapies no longer work or if you no longer want them, you might find comfort in hospice care. Hospice care provides medical, emotional and spiritual support. Hospice care focuses on keeping you comfortable and easing your physical and emotional pain.
Start by making an appointment with a doctor or other healthcare professional if you have symptoms that worry you. Tell your healthcare professional if you were treated for cancer in the past, even if the treatment was many years ago. If you're diagnosed with bone metastasis, your health professional may refer you to a specialist. Often this is a doctor who treats cancer, called an oncologist.
Here's some information to help you get ready for your appointment.
For bone metastasis, some basic questions to ask include:
Your healthcare professional is likely to ask you questions, including:
