Introduction
What is metastatic bone disease?
Metastatic bone disease, also known as bone metastasis, occurs when cancer cells from a primary tumour in another part of the body spread (metastasize) to the bones. This secondary involvement of the bones by cancer cells is relatively common, and the most common cancers that metastasize to the bones include breast, prostate, lung, kidney, and thyroid cancers. Cancer cells can travel through the bloodstream or lymphatic system from the primary tumour to the bones, where they establish secondary tumours or metastatic lesions.
The process of metastasis involves cancer cells breaking away from the primary tumour, entering the bloodstream or lymphatic system, and establishing secondary tumours in distant sites, including bones.
Common sites include the spine, hips, pelvis, and long bones are common sites for bone metastasis. However, it can affect any bone in the body. Metastatic bone disease can cause pain, fractures (due to weakened bones), hypercalcemia (elevated calcium levels), and other symptoms depending on the location and size of the metastatic lesions.
Symptoms
Symptoms of metastatic bone disease can vary based on the location and extent of bone involvement. Common symptoms may include bone pain – persistent, localized pain in the affected bone is a common symptom. The pain may be aching or sharp and can worsen with movement or at night. Bone on weight bearing is a concern especially if you experience a limp. This may indicate an impending fracture of bone. Weakened bones due to metastatic lesions are more prone to fractures. A fracture may occur with minimal trauma or stress on the bone.
Other generalised symptoms include limited range of motion of the joint due to stiffness, Hypercalcemia which may cause symptoms such as nausea, constipation, confusion, and increased thirst and urination.
If metastatic lesions affect the spine, compression of the spinal cord can cause neurological symptoms such as weakness, numbness, or difficulty walking and can be a surgical emergency.
It’s important to note that these symptoms can overlap with other conditions, and the presence of these symptoms doesn’t necessarily confirm metastatic bone disease. If you are experiencing persistent symptoms or have concerns about your health, it’s crucial to consult with a healthcare professional.
Diagnosis
Diagnosis of Metastatic Bone Disease involves imaging studies such as X-rays, CT scans, MRI, or bone scans to visualize the presence and extent of metastatic lesions. A biopsy may be performed to confirm the presence of cancer cells.
Once a diagnosis of metastatic bone disease is confirmed, additional tests may be conducted to determine the primary source of cancer and its characteristics. This information is crucial for guiding treatment decisions. The healthcare team, often including oncologists and orthopaedic specialists, will work together to develop a comprehensive treatment plan that may involve surgery, radiation therapy, systemic therapies (chemotherapy, hormone therapy, targeted therapy), and supportive care to manage symptoms and improve the quality of life. Early and accurate diagnosis is essential for effective management of metastatic bone disease.
Treatment
Treatment aims to manage symptoms, control the spread of cancer, and improve quality of life. Approaches may include radiation therapy, surgery, systemic therapies (chemotherapy, hormone therapy, targeted therapy), and supportive care. The key is also to avoid pathological fracture of bone.
Metastatic bone disease is typically considered advanced cancer, and treatment strategies often focus on palliative care to relieve symptoms and improve the patient’s comfort. It’s important for individuals with a known primary cancer to be vigilant about symptoms and work closely with their healthcare team to monitor for potential metastasis. Early detection and appropriate management are crucial aspects of care for those with metastatic bone disease.
Further information
It’s important to note that while metastatic bone disease is more frequently associated with advanced cancer, not everyone with cancer will develop bone metastases. Advances in cancer treatments and early detection have improved outcomes for some individuals with metastatic bone disease, allowing for more effective management of symptoms and quality of life. If you have concerns about the possibility of bone metastases or are experiencing symptoms, it’s crucial to consult with your healthcare team for proper evaluation and guidance.
If you have concerns you should consult your GP in the first instance. For more information on how the Manchester Lumps Clinic can help, contact us to arrange a consultation.
