Can bone metastases be cured?

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Bone metastases, sometimes known as secondary bone cancer or bone secondaries, occur when cancer cells from a primary tumor spread to the bone.

They differ from primary bone cancer, which is when cancerous tumors originate within the bone tissue. However, this type of cancer is rare.

What causes them?

Bone metastases can occur because of almost any cancer, and they happen when tumors elsewhere in the body spread to the bones. The most common types of cancer which cause bone metastases include:

• breast cancer
• prostate cancer
• lung cancer
• kidney cancer
• thyroid cancer

Bone metastases are particularly prevalent in people with prostate and breast cancer — according to 2018 research, 70% of individuals with metastatic breast and prostate cancer had them.

Symptoms

Common symptoms of bone metastases include:

• Pain: This is frequently the first symptom of bone metastases. The pain may worsen over time.
• Fractures: Bone metastases weaken the bone, making fractures more likely.
• Spinal cord compression: This occurs if the bone metastases occur in the back and may cause neck or back pain. It can be an emergency as in some cases, it may cause permanent spinal cord injury or death.
• High blood calcium levels: As bones dissolve, they can release calcium into the bloodstream. This can increase calcium levels, which is also known as hypercalcemia.

In most cases, doctors cannot cure bone metastases. However, treatment can help to stop or slow their growth. The treatment may also help to strengthen the bones and eliminate or reduce some symptoms, such as pain.

It is important that healthcare professionals find and diagnose bone metastases as early as possible so they can implement treatment and reduce the likelihood of any serious complications.

The statistics on survival rates for bone metastases vary, but typically, the earlier a person receives treatment, the higher the survival rate. According to a 2021 study, the average survival time in individuals with bone metastases is nine months.

People with lung cancer who developed bone metastases had the shortest survival rate.

Research states that the lifespan of an individual with bone metastases is limited. Therefore, treatment for this condition focuses on improving function, reducing symptoms, and maintaining quality of life.

It is key to identify bone metastases as early as possible. If a person receives prompt treatment, they can slow the spread of the cancer, limiting symptoms and complications.

To diagnose bone metastases, a healthcare professional may conduct scans. These can include:

• X-ray
• CT or CAT scan
• MRI scan
• PET scan
• bone scan

Healthcare professionals will usually conduct these tests if a person with cancer is experiencing pain, fractures, weakness, or any other symptom of bone metastases.

As bone metastases do not have a cure, treatments are mostly for managing symptoms and limiting the spread. The type of treatment will depend on the type of cancer, the location and amount of bone metastases, and the treatments a person has already had.

Radiation therapy

Radiation therapy may be beneficial in reducing pain that relates to bone metastases. This type of therapy uses high-intensity radiation to attempt to destroy cancerous cells.

Pain medication

One of the first lines of treatment may be pain medication. This is available in various forms, including pills, patches, and pumps.

Anti-inflammatory medications, opioids, pain medications for nerve pain, and steroids are some types of pain medication a person may receive.

Chemotherapy

A person may receive chemotherapy as a treatment for bone metastases when these are present in various parts of the body.

Unlike radiation therapy, chemotherapy travels through the whole body, so it can provide treatment to different areas at once. However, this also means it has more extensive side effects.

Bisphosphonates

Bisphosphonates are drugs that can help to strengthen bones. This may reduce the likelihood of a person breaking a bone and can also help reduce pain symptoms.

Doctors often use these medications in the treatment of osteoporosis. These can also reduce calcium levels, so they may be beneficial for those experiencing hypercalcemia as a result of bone metastases.

A person may also receive large amounts of intravenous fluids in conjunction with bisphosphonates to treat hypercalcemia, as these fluids can help protect the kidneys

Surgery

People experiencing fractured or very weak bones may need surgery.

Healthcare professionals can perform surgery to strengthen weak bones by placing metal plates and screws. Additionally, if a bone is already broken, a surgeon may place a steel support over the broken area.

If bone metastases affect the spine, surgeons can inject bone cement into the base of the spine to help support it.

A person should discuss their condition with a doctor and ask any questions that they have. Individuals may find it helpful to write a list of questions beforehand.

Some possible questions to ask include:

• What are the treatment options and side effects?
• What tests am I likely to undergo?
• Are the bone metastases in one area or spread around the body?
• How will this affect any current treatment?
• Is there any support available, in the form of literature, groups, or websites?
• What is the outlook?

Bone metastases develop as a result of cancer in another area of the body spreading to the bone. This is possible for almost all types of cancer.

There is no cure for bone metastases. Treatment options generally focus on reducing pain, treating broken bones, and strengthening bones.

In some cases, bone metastases can lead to complications, including spinal cord compression and high calcium levels.