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Bone Metastasis

Certain types of cancer can spread from the part of the body where it started to another part (or parts) of the body. These cells can travel through the lymphatic channels and become lodged in nearby lymph nodes or can travel through the bloodstream to a different part of the body. Many times these cells die but sometimes they do not and land in a new location. When this happens and these cells begin to grow in this new place this spread to the new part, of the body is called "metastasis." Bones are a common place for these cells to settle especially the spine, pelvis, hip, upper leg bones and the skull.

This is not the same as "bone cancer" which is cancer that begins in the cells of the bone and continues to grow there and the treatment recommendations will be different.

When the cancer has spread from the place where it started to another body part, it continues to be called by the name of the body part where the cancer began. For instance, if a breast cancer spreads to the bones, it is considered "breast cancer with bone metastasis."  Bone metastasis is a frequent cause of pain for individuals with cancer that has spread. It can also cause bones to break or leads to high calcium levels in the blood. Both situations require rapid treatment.

Risk Factors

Although it may occur with other types of cancer, breast, prostate, lung, kidney and thyroid cancers are the cancers that have the greatest likelihood of spreading to the bone.

Diagnosis

Pain is usually the first sign that cancer has spread to the bones. Often the pain begins as a mild pain that is relieved with movement. Over time, the pain worsens, limits your ability to perform activities and may begin to keep you awake at night. Sudden, severe pain in the back, hip, upper leg or other bones may indicate a break in a bone due to the spread of cancer to that site.

When bone metastasis is suspected your doctor will order an X-ray, bone scan, CT or MRI scan to confirm the diagnosis.

Treatment

The treatment recommendations will vary depending on multiple factors including the site of the primary cancer, the location and number of bones involved with cancer and if the bones are weakened or broken.

Surgery

Surgery is sometimes necessary to stabilize a bone that has broken before other therapy can be given.

Chemotherapy and/or Hormone Therapy

Medication to treat the original cancer and/or to strengthen the affected bone(s) may be recommended depending on the original site of the tumor.

Radiation Therapy

External beam is given to specific bones to destroy the cancer in this area. It may be used to alleviate pain or other symptoms.  This therapy is a series of painless, daily (Monday through Friday) outpatient treatments delivered over a short period of time. Sometimes the radiation is given as one large treatment to a specific site, but more often it is given as smaller doses each day over several days. It is given only to the area where the cancer is located.

There are certain circumstances when the radiation therapy treatment needs to be started urgently or while you are in the hospital. One of these situations would be if you have symptoms that mean a tumor in the spine is pressing on the spinal cord (intense back pain, sudden leg weakness or inability to walk, sudden loss of sensation in extremities, not able to urinate or move your bowels.) Then your radiation therapy treatment will be started immediately to relieve the pressure on the spine.

Treatment Side Effects

Side effects of the therapy can vary depending on the area under treatment. Possible side effects include skin irritation and redness (similar to sunburn), fatigue and hair loss in the treatment area. Some additional side effects may be related to medications, including steroids (Decadron or dexamethasone) which are given to alleviate symptoms caused by the cancer.

Call us today at 401.432.7446  to learn more about treatments and options.  Our oncology team is ready to support you.

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