Symptoms and treatments for bone metastases

Metastases are tumor cells that have separated from its main body and spread to other healthy organs and tissues. Their presence significantly complicates the treatment process, worsens the course of the disease and increases the likelihood of relapse. To help the patient, it is necessary to remove not only the formation, but also to find and destroy the remaining pathological cells. The most common places of their distribution are the brain, lymph nodes, lungs, bones.

Bone metastases are caused by almost any advanced oncological disease. This happens when cancer cells from the primary focus spread to bone tissue, infecting them and forming new malignant formations. This causes poor blood flow and causes frequent fractures and difficulty moving.

What types of cancer cause bone metastases?

Bone metastases in cancer is a secondary process that occurs against the background of oncology. Tumor cells are transported to the bones through the bloodstream. But the affected cells are capable of metastasizing only when they reach a certain maturity. The pathological process occurs at 3-4 stages of any type of oncology.

Metastasis to the bone system is possible in almost any oncological pathology. But the greatest number of cases is observed with cancer of the breast and prostate, it occurs less often when the lungs and organs of the gastrointestinal tract are damaged by the oncological process, sometimes with neoplasms of the brain and ovaries.

Which bones are affected in cancer?

In theory, cancer cells can infect all bones, but they are more likely to linger in places with a good blood supply, which allows them to eat well and multiply quickly.

It is extremely rare that the small bones of the hand and foot become the site of localization. Most often, secondary tumors are found in the vertebrae, ribs and pelvic bones of the skeleton, which are well supplied with a whole network of blood vessels. Also, the bony part of the head is often attacked, except for the facial region.

The most dangerous are the formations that develop in the vertebrae and tubular bones. They most often cause damage to the integrity of the bone. Damage to the cervical vertebra threatens with paralysis due to compression of the spinal cord bone fragments.

What are bone metastases?

There are several types of bone cells. Depending on which of them are affected, there are several types of bone metastases.

They are:

Osteolytic - the penetration of atypical cells into osteoclasts provokes bone tissue atrophy, which threatens fractures. With the further development of the disease, the smallest load can provoke complications (even getting out of bed or walking);
Osteoblastic - affecting osteoblasts, atypical cells cause the proliferation of bone tissue, which is manifested by the appearance of growths and protrusions, impaired articular mobility;
Mixed - simultaneous damage to cells of 2 types. This is the most common pathology. With its development, new metastases appear and bone thinning occurs.

The appearance of any type of bone formation is accompanied by a number of negative symptoms.

What are the symptoms and signs of metastatic bone disease?

At first, with a small lesion area, clinical manifestations are practically not observed. But in the absence of anticancer therapy, the pathological process is actively developing and begins to manifest itself with certain symptoms.

Signs of bone metastases:

Pain is the most common symptom. At the initial stages of the process, it is removed with conventional painkillers, but over time it becomes more and more intense and causes severe suffering to the patient. Particularly painful sensations increase when, with the further development of the tumor, it spreads to the nerve endings of nearby tissues;
Impaired articular mobility and motor function;
Pathological fractures - appear due to the gradual destruction of bone tissue, which leads to disability;
Deterioration in the activity of the CVS and excretory organs - arises as a result of an increased content of Ca in the blood. These disorders require immediate treatment;
Weakness, weight loss, poor appetite are common signs of increasing intoxication;
Swelling, induration, bumpy surface - these symptoms of bone metastases can be detected by palpation, but only in cases where the tumor is already quite large;
Compression syndrome - manifested by compression of the spinal cord and deterioration of motor function. With the defeat of the pelvic bones, the work of the pelvic organs worsens.

Metastases manifest in different ways. Symptoms depend on the extent of the lesion and the effectiveness of the therapy.

How to identify bone metastases - diagnostic methods

Signs of metastasis are not always possible to identify at the initial stage. It is possible to suspect the development of a secondary process if fractures often begin to occur in a cancer patient, spinal compression develops, and a number of other symptoms appear. Comprehensive diagnostics helps to identify metastases in time.

It includes:

Scintigraphic examination - it is based on radiation diagnostics. Radioactive isotopes help to detect metastases in bones;
X-ray examination - determines the type of disorders, but is effective only with extensive metastasis;
CT is a highly informative method widely used in the diagnosis of bone metastases;
MRI is also one of the most effective methods. It makes it possible to assess the degree of damage, to identify the spread of tumor cells to nearby organs;
Biochemical research - helps to determine the amount of Ca in the blood and identify hypercalcemia;
Biopsy - the procedure makes it possible to confirm the cancerous nature of the formation and establish a final diagnosis.

Attention! Bone metastases require the same treatment as the primary tumor. Diagnostics helps to determine the features of the process and to build a therapeutic tactics.

How to treat bone metastases - basic methods

Treatment of bone metastases in cancer is aimed at reducing the intensity of pain, preventing fractures, and slowing down the development of other complications. For these purposes, various methods of treating bone metastases are used.

Pain relievers

With the help of analgesics, pain can be reduced in 90% of patients with cancer diagnosis. However, the occurrence of uncontrollable pain is still a problem that has not yet been fully resolved.

A 10-point scale is used to assess the intensity of pain. WHO recommends the choice of pain relievers depending on their manifestations.

Doctors prescribe:

Neopioids - for mild to moderate pain (1-3 points). This group of medicines includes non-narcotic analgesics and NSAIDs;
Opioids - for moderate and severe pain (4-6 points). These patients are not always helped by treatment with non-opioids. Therefore, they are prescribed narcotic analgesics. These are prescription drugs;
Strong opioid analgesics - for very intense pain (7-10 points). A special recipe is required to purchase them. Additionally, NSAIDs and simple pain relievers are used.

Analgesics have side effects that include drowsiness, constipation, nausea, and dizziness.

Advice! The effect of painkillers is never long-term. Therefore, you need to take drugs either immediately when pain occurs, or regularly.

Bisphosphonates

These drugs can help reduce bone breakdown, the risk of fractures, and pain. Their action is based on the effect on osteoclasts.

Normally, all cells periodically die off and are replaced with new ones. In bone tissue, osteoclasts (destroy old cells) and osteoblasts (promote recovery) are responsible for this. But with oncology, the process develops too quickly - cancers secrete substances that stimulate the activity of osteoclasts. This leads to the fact that old cells are destroyed faster than new ones are formed.

The mechanism of bisphosphonates is not fully understood. But it is believed that they inhibit the action of osteoclasts, thereby preventing tissue destruction. Studies have shown that patients treated with bisphosphonates had fewer fractures, decreased blood calcium levels, and less need for radiation therapy. Also, preventing or slowing down negative processes helped to reduce pain.

Radiation therapy

This type of treatment is effective in relieving pain and preventing cancer from spreading further. When undergoing radiation therapy, each patient is concerned about whether bone metastases can be removed. It is impossible to give an unequivocally positive answer to this question. But we can say with confidence that the method is quite effective when metastatic lesions are grouped in one area.

One of the most commonly used methods is radio medication. When using it, a radioactive substance is injected into a vein. Once in the body, it attaches to the affected areas of the bone. Such a targeted effect allows you to effectively destroy cancer cells and fight negative symptoms.

The method has side reactions - it provokes bleeding and increases the likelihood of leukemia (rarely).

Chemotherapy

The most commonly used medicinal method. The use of chemotherapy makes it possible not only to suspend the process of metastasis, but also to reduce pain and reduce the risk of fractures. It is carried out for a long time. The disadvantage of this method is side reactions in the form of gastrointestinal tract disorders, nausea, vomiting, bone marrow damage. But modern drugs cause negative symptoms much less frequently.

Surgical removal of metastases

Surgical methods also help to fight bone formation. When removing metastases, surgeons eliminate the lesion and nearby tissues. This tactic brings good results, but requires a long recovery. Recently, minimally invasive surgical methods are becoming more widespread.

Surgical treatment is also used for fractures, to relieve spinal compression and restore articular mobility. Orthopedic surgery techniques are used to support long bones.

What is the prognosis of life expectancy for bone metastases?

Many factors influence a positive outcome. Life expectancy largely depends on the severity of the underlying disease and general condition. For example, the average life expectancy for metastases of bone tumors provoked by thyroid cancer or myeloma is 4 years. The most unfavorable prognosis for metastasis against the background of oncological lesions of the lungs, liver, skin, kidneys.

Can bone metastases be cured? A favorable outcome is influenced by:

the main diagnosis (the morphological structure of the formation, the degree of its malignancy, the characteristics of the course of the disease matter);
general state;
accompanying violations and their correction;
the degree of spread of the pathological process;
well-chosen methods of therapy;
patient compliance with all medical recommendations and regular observation.

All these factors are important for a favorable prognosis and an increase in life expectancy.

Prevention of bone cancer

Today, scientists have not yet been able to fully figure out the exact causes of the oncological process. Therefore, specific methods of prevention do not yet exist. To prevent oncology with subsequent metastasis in the bone, it is important to lead an active lifestyle, eat a balanced diet, and treat fractures on time.

The fight against metastases is more effective at the very beginning of their development. Therefore, all cancer patients should be under medical supervision, periodically undergo the necessary examinations and immediately seek help if their condition worsens.