Bone Metastases: Symptoms And Treatment

Bone metastases are a complication of advanced cancer. Their presence indicates an accentuated severity of the oncological pathology. In this article, we will talk about possible options in this regard.

Bone mestastases (or bone metastases) are the evolution of certain forms of cancer that worsen, affecting the stage of the disease. It is, in simple terms, the transfer of neoplastic cells from a tumor of a specific organ to the bones.

We must emphasize that bone metastasis does not indicate a primary form of bone cancer. This means that the disease did not originate in bone tissue, but in another organ, such as the breasts or lungs.

We can say that all bones are potentially subject to metastases, although they mainly affect the spine and long bones. This is because of the way blood and lymphatic circulation drain fluids.

When a neoplastic cell originating elsewhere settles in a bone, a process of duplication begins at this new point. Bone metastasis tends to produce substances that stimulate the cells of the bone tissue: osteoblasts and osteoclasts. This stimulation is excessive and the tissue suffers the consequences.

The tissue that lines the bone metastases weakens due to the action of the osteoclasts  or hardens due to the intense action of the osteoblasts. Both of these processes are harmful.

Metastases can occur in most cancers, but these are mainly found in breast and prostate cancers. Once the transfer has taken place, the symptoms mix between those of the primary tumor and those originating from metastatic progress.

Symptoms of bone metastases

Bone metastases share common symptoms, in addition to those typical of the primary tumor from which they originate. Common symptoms include:

• Pain: This is one of the most characteristic symptoms of bone metastases. It may or may not be persistent pain. In some patients the movement aggravates it, while in others it is present at any time, although at rest, which hinders the effectiveness of the therapy.

• Fractures : as already mentioned, metastases weaken the bone tissue. A weakened bone is more prone to fractures and to break with minimal effort. In cancer patients, it is essential to prevent fractures.

• Hypercalcemia: The wound that causes bone tissue to metastasize releases calcium into the blood. As calcium levels rise, symptoms such as constipation, loss of appetite and polyuria (excessive urination) occur. Without appetite and with excessive urine production you can experience dehydration.

• Compression : One of the most common sites for bone metastasis is the spine. Damaged vertebrae can shrink, cross over each other, or change position. As a result, the nerves or spinal cord experience some pressure.

Treatment of bone metastases

There are two ways in which it is possible to intervene to treat bone metastases. You can proceed with a systemic or a localized approach. The choice depends on the original type of cancer, the patient’s clinical condition and the availability of these treatments on site. Let’s see some of them.

Systemic options

• Chemotherapy : This is the administration of drugs that block the reproduction of cancer cells. It is the most popular option.

• Radiotherapy : through a radiation emitted by a specialized machine, it penetrates the body to destroy cancer cells. The amount of sessions and the radiotherapy dosage varies from patient to patient. It is usually very effective for controlling pain caused by bone metastases.

• Hormone therapy : consists of the administration of drugs that block specific hormones. It is a therapy of choice for breast or prostate cancer.

• Immunotherapy: this is also based on drugs, but in this case it is medicines that are developed in order to emulate the functions of the immune system.

• Radiopharmaceuticals : in this case the radiation comes from inside the body, and not from an external source. Radiopharmaceuticals are injected into the patient’s body, travel to the bone metastases and from there they radiate to the cancer cells, which they remain alongside.