Bone Metastases: Symptoms And Treatments

Bone metastases are the development of certain types of cancer that end in a serious complication that affects the bones. Neoplastic cells from a tumor in an organ are basically transferred to the bone.

We must first emphasize that bone metastases are not the presence of primary cancer in the bones. In other words, the disease does not begin in bone tissue, but in other organs such as the chest or lungs.

This means that the disease spreads to the bones. As a rule, however, it spreads to the spine and the bones of the lungs. This is about the way the bloodstream and lymphatic system drain the fluid in the body.

When a neoplastic cell reaches the bone, it begins to multiply. Bone metastases usually do something that stimulates the cells in bone tissue: osteoblasts and osteoclasts. It is then stimulated too much and the tissues will suffer.

Then the tissues become weaker due to the osteoclasts  or they become harder due to the osteoblasts. Whatever happens, it is harmful.

Most types of cancer can also metastasize, but it is more common for breast and prostate cancer. When this happens, patients have symptoms of both the primary tumor and the new ones that are spreading.

Symptoms of bone metastases

Different types of bone metastases share common symptoms, in addition to the various tumors that cause them. Some of the usual signs are:

• Pain:  This is the primary trait. However, it may or may not be persistent pain. In some patients, it gets worse with movement, while others feel it all the time, even when resting. This can make treatment difficult.
• Bone fractures:  As we have already mentioned, metastases can weaken the bone. A weak bone is more likely to break with minimal effort. It is important for cancer patients to be very careful to avoid bone fractures.

• Hypercalcemia:  The tumor can actually cause the release of calcium into the bloodstream. As it gets worse, more symptoms will appear. For example, patients experience constipation, poor appetite and frequent urination. Without appetite and with plenty of urination, one can easily become dehydrated.
• Compressions. One of the most common places to see bone metastases is in the spine. Damaged vertebrae can shrink in size, overlap and change position. Then the nerves or the spine can become pinched.

Treatment of bone metastases

There are two ways to treat it. One can choose a more localized or systemic approach. The choice will depend on the initial type of cancer, the patient’s clinical condition and the treatments available. Let’s take a closer look at it.

Systemic possibilities

•  Chemotherapy:  This uses drugs that disrupt some of the processes in the cancer cells. This is usually the most common option.
• Radiation therapy:  Through radiation from special equipment, it penetrates the body to destroy cancer cells. The number of treatments and the dosage of radiation therapy vary from patient to patient. It is usually very effective in controlling pain from bone metastases.
• Hormone therapy:  This uses drugs that block certain hormones. It is a treatment that is common for breast cancer and prostate cancer.
• Immunotherapy:  This also uses drugs, but they mimic the functions of the immune system.
• Radiopharmaceuticals:  In this case, the radiation is emitted from the inside of the body and not with equipment from the outside. The radiopharmaceutical is injected into the patient’s body, where it travels to bone metastases and then attacks cancer cells.

Localized opportunities

• Bisphosphonates:  Bisphosphonates block the action of osteoclasts to prevent them from destroying healthy bones.
• Denosumab:  Like bisphosphonates, denosumab also blocks osteoclasts. It works a little differently than the others, but it gives similar results in the end.
• Vertebroplasty:  When there are bone metastases in the spine, there is an alternative to direct injection of fast-acting bone glue. It’s called vertebroplasty. It is actually effective enough to relieve the pain.
• Surgery:  As a last resort, surgical treatment is available if certain conditions are met. If the metastasis is available, a surgeon can operate and remove as much as possible.

Management of bone metastases

The development of bone metastases is a serious complication of cancer. It is important for the patient to  have a team of trained professionals who can provide the best possible solutions. With the new forms of treatment available, it is possible to improve the quality of life of the person suffering from this disease.