Bone metastasis forms a cancerous mass by settling in the bone through various complex cancer mechanisms that occur in any organ in the body.
Cancer can spread from one part of the body (primary site) to another, including the bones. Various cancers, such as breast, lung, prostate, and kidney, spread more commonly to the bones. Bones are also affected by cancers that start in the bones, such as multiple myeloma, that can apply to numerous areas of the bones.
Cancer cells that have spread to the bone upset the balance between the activity of osteoclasts and osteoblasts, the two cell types that generally maintain bone quality. Dysfunctional osteoclasts or osteoblasts can cause bone weakness or overproduction.
Which Cancers Most Commonly Metastasize to Bone?
Cancer can spread from one part of the body (primary site) to another, including the bones. Bones are also affected by cancers that start in the bones, such as multiple myeloma, that can spread to numerous areas of the bones.
Every cancer has the potential to metastasize to the bone. But the most common breast and prostate cancer metastasizes to the bone. Less frequently, lung, thyroid, bladder, kidney, and colorectal cancer are among the cancers that can metastasize to the bone.
Bone Metastasis Signs and Symptoms
Diagnosing and treating bone metastases early can help prevent problems or lessen their effects.
Pain in Bones
Bone pain is often the first sign of cancer that has spread to the bone. Pain may come and go at first. It tends to be worse at night and may get better with movement. It may then become constant and worsen during activity. The bone may be so weak that it breaks. This can usually be prevented if bone metastases are found early.
Fractures in Bones
Fractures can happen with a fall or injury, but a weak bone can also break during everyday activities. These breaks often cause sudden, severe pain. Fractures most commonly occur in the long bones of the arms and legs and the bones of the spine. For example, sudden pain in the middle of the back may mean that a bone in the spine is broken.
Spinal Cord Compression
Cancer growing in the backbones can put pressure on the spinal cord. One of spinal cord compression’s earliest symptoms is back or neck pain.
A person may become paralyzed if spinal cord compression is not treated immediately. This usually affects the legs (so the person cannot walk), but if the tumor is pressing on the spinal cord in the neck, the arms and legs may be affected.
Spinal cord compression can occur in different ways:
- Back pain (sometimes with pain going down one or both legs)
- Numbness in the legs or abdomen
- Leg weakness or trouble moving your legs
- Loss of urine or stool control (incontinence) or problems urinating
- If such symptoms are noticed, seek medical advice immediately.
High Blood Calcium Levels
When cancer has spread to the bones, too much calcium from the bones can release into the bloodstream. This is called hypercalcemia.
High blood calcium levels can cause problems such as:
- Constipation
- Frequent urination
- Feeling sluggish or sleepy
- Constantly feeling thirsty and consuming plenty of fluids
- Muscle Weakness
- Muscle and joint pain
- The blurring of consciousness, confusion
- Coma
- Kidney failure.
Is Bone Metastasis Common?
Bone metastasis is a prevalent problem. According to some studies, it is the most common site for metastases, while according to some studies, it is the third most common site for metastasis after lung and liver metastases. In autopsy studies, it was determined that 70% of breast and prostate cancer patients and 35-42% of lung, thyroid, and kidney cancer patients had bone metastases. In addition, the incidence of bone metastases is increasing due to the increase in survival with new treatments.
In Which Bones Do Bone Metastases Occur Most? Is There A Reason For This?
Although bone metastases can be seen in any bone, they are most common in the spine, pelvis, and thigh bones near the hip. The main reasons for the frequent occurrence of bone metastases in these regions are the regions where the bone marrow is more active and the widespread venous networks around the spine.
Treatment Of Bone Metastases
Bisphosphonates: Bisphosphonates are drugs used to treat bone damage caused by metastases.
Radiation Therapy: Radiation provides pain relief and control of the growth of tumor cells in the area of bone metastasis. It can be used to prevent fractures or as a treatment for spinal cord compression.
Surgery: Surgical treatment for bone metastases is done to prevent or treat a fracture. As part of treatment, the tumor is usually removed, and the bone is stabilized to avoid rupture. Metal rods, plates, screws, wires, nails, or pins are surgically inserted to strengthen or restructure the bone damaged by metastasis.
Other: Treatments for bone metastases and their symptoms include physical therapy and drug and non-drug approaches to control pain.
The best way to treat bone metastases is to treat primary cancer effectively. In addition to cancer treatment, there are several treatment options for bone metastases. These include chemotherapy, hormone therapies, targeted therapies, and immunotherapies.