Metastatic Bone Disease

Secondaries of bone, also known as bone metastasis, refer to cancer that has spread from another part of the body (like the breast, lungs, or prostate) to the bones. These secondary cancers are not originally from the bone but have traveled there through the bloodstream or lymphatic system.

The most common bones affected by secondaries are:

Spine (vertebrae): It's one of the most common areas for cancer to spread.

Hips (pelvis): This is another common site for metastatic cancer.

Ribs: These bones can also be affected by secondary cancers.

Legs (femur): The thigh bone is also commonly involved.

Arms: The upper limbs, though less common, can also develop bone metastases.

Pain in the affected bone, which might be constant or worse at night.

Swelling or a noticeable lump near the affected bone.

Fractures (broken bones) that happen more easily due to weakened bone structure.

Numbness or weakness if the cancer affects nerves around the spine.

Fatigue or unexplained weight loss.

Radiation therapy: To shrink the tumor and reduce pain.

Chemotherapy: To target and kill cancer cells that have spread to the bone.

Hormone therapy: If the cancer is hormone-sensitive (e.g., breast or prostate cancer), this can help slow the cancer's growth.

Surgery: In some cases, surgery is done to remove the tumor, stabilize the bone, or repair fractures.

Targeted therapy: Medicines that target specific cancer cells.

Worsening pain: The pain can become severe and interfere with daily life.

Bone fractures: As the cancer weakens the bone, it becomes more likely to break with minor injury.

Increased difficulty moving: If the bones are weakened or broken, it can make it harder to walk or use the affected limb.

Spreading of cancer: The cancer could spread further to other bones or organs, making it more difficult to treat.

Surgery for bone metastasis is generally done carefully to avoid spreading the cancer. When done by a specialist like an orthopedic oncologist, the risk of spreading cancer is minimized. Surgeons use special techniques to remove the tumor or stabilize the bone without causing the cancer to spread. However, it’s always important to carefully plan the surgery and follow up with other treatments like chemotherapy or radiation to control the cancer.

Pain Relief:

Surgery is often done to relieve severe pain caused by the metastatic tumor. When cancer spreads to the bone, it can weaken the bone structure and cause significant pain. Surgery can help remove the tumor or stabilize the bone to reduce pain.

Bone Stabilization:

Bone stabilization is a major goal. In some cases, cancer can weaken bones to the point where they may fracture easily. Surgery can involve reinforcing the bone with metal plates, screws, rods, or prostheses, which helps prevent fractures and maintains the bone's structural integrity.

Improving Mobility and Function:

If the tumor or weak bones are affecting the ability to move or use the limbs, surgery can help restore mobility and improve function. This can make it easier for the patient to walk, move around, or perform daily activities, improving their overall quality of life.

Prevention of Fractures:

Surgery can be done to prevent fractures, especially in areas where the bone is severely weakened by cancer. For example, if a tumor is present in a bone that is at risk of breaking, surgery can help stabilize that bone before a fracture occurs.

Tumor Removal:

In some cases, the surgeon may aim to remove the tumor if it is possible to do so safely. This helps to reduce the size of the tumor, control its spread, and may provide some symptom relief. However, surgery for bone metastasis is usually not curative since the cancer has already spread, and additional treatments

Improving the Overall Quality of Life:

Ultimately, surgery in bone metastasis is focused on improving the patient's quality of life by making them more comfortable, reducing pain, and helping them maintain independence in daily activities. It is aimed at controlling symptoms and not necessarily curing the cancer.