Metastatic bone cancer

Some types of cancer begin in the bones. These true "bone cancers" include osteosarcoma, chondrosarcoma, Ewing tumor, and others. Most cancers that affect the bones, though, begin in some other organ or tissue and spread (metastasize) to the bones. This is called metastatic bone cancer. After the lungs and liver, the skeleton is the most common destination for cancers that arise in other parts of the body.

The growth of cancer cells in bones can cause pain or broken bones. Pain that occurs without physical activity is especially worrisome.

Almost any type of cancer can spread to the bones. The most common ones include:

• breast cancer
• lung cancer
• thyroid cancer
• kidney cancer
• prostate cancer

Sometimes a bone metastasis is the first sign a person has cancer. It may also be the first sign that cancer has recurred after cancer treatment.

Symptoms of metastatic bone cancer

The most common symptom of metastatic bone cancer is pain. The most common sites of spread — spine, pelvis, ribs, skull, upper arm, and long bones of the leg — tend to be where metastatic bone pain occurs.

Other symptoms include:

• broken bone. Bones weakened by cancer break more easily. A broken bone from a minor injury, or no injury at all, should be thoroughly checked out.
• anemia. Bones make red blood cells. Cancer in bones can slow or halt red cell production.

Diagnosing metastatic bone cancer

Your description of your symptoms and medical history are an important part of diagnosing metastatic bone cancer. Your doctor will do a physical exam that focuses on the painful areas. A number of tests can also help make the diagnosis. Which ones you need depend on your situation.

• x-rays
• bone scan
• CT and/or MRI scan
• positron emission tomography (PET) scan
• complete blood count
• blood chemistry analysis
• urinalysis
• bone biopsy

Treating metastatic bone cancer

Treatment of metastatic bone cancer tends to focus on relieving symptoms, and is often not intended to eradicate or cure the cancer. Treatment options depend on the location and extent of the metastases. They include:

• Medications such as bone-building drugs can help shore up bones and reduce pain.
• Chemotherapy can destroy cancer cells in the bones.
• Hormone therapy may be used if the original cancer, such as breast or prostate cancer, is sensitive to hormones.
• Pain medications help ease pain caused by bone metastasis.
• Radiation therapy can kill cancer cells in bones and other tissues.
• Surgery can stabilize a fragile bone or repair a broken bone.