Metastatic bone cancer: Understanding the symptoms, treatment, and prognosis

Metastatic bone cancer is a serious condition that often signals advanced-stage cancer, leading to significant complications such as pain, fractures, and reduced mobility.

Mr Guy Morris, renowned consultant orthopaedic surgeon, provides a comprehensive overview of metastatic bone cancer, including symptoms and available treatments.

What is metastatic bone cancer?

Metastatic bone cancer develops when cancer cells from the primary tumour (the original location) spread to the bones. It's important to know, however, that metastatic bone cancer is different from primary bone cancer, which originates directly in the bones. In metastatic cases, the cancer starts elsewhere in the body - commonly in the breast, prostate, lungs, or kidneys - and then travels to the bones via the bloodstream or lymphatic system.

Once the cancer reaches the bones, it can then cause serious complications. Metastatic bone cancer weakens the bones, making them more susceptible to fractures. While the most frequently-affected bones are the spine, pelvis, and ribs, metastasis can occur in any bone.

What are the symptoms of metastatic bone cancer?

The most common symptom is bone pain, which can range from mild discomfort to severe, debilitating pain. This pain is often persistent, worsening over time, and may be more pronounced at night or with physical activity.

In addition to pain, other symptoms may include:

• pathological fractures
• swelling and tenderness
• reduced mobility
• numbness, weakness, or even paralysis
• hypercalcaemia (elevated calcium levels)

As the cancer spreads, it can also lead to widespread symptoms such as fatigue and weight loss.

Is metastatic bone cancer curable?

Unfortunately, metastatic bone cancer is generally not curable. The spread of cancer to the bones indicates that cancer has progressed to an advanced stage, and curing it becomes extremely difficult.

However, treatments are available that can control the spread of cancer, alleviate symptoms, and improve quality of life. With the right treatment, many patients with metastatic bone cancer can live for months, and in some cases, even years.

How is metastatic bone cancer treated?

The treatment of metastatic bone cancer is multifaceted and usually palliative, meaning it focuses on pain relief, bone strengthening, and slowing the progression of cancer. Several treatments are used, including:

Medications

Medications are used to control pain, reduce bone damage, and manage other symptoms. Common drug options include non-steroidal anti-inflammatory drugs, bone-strengthening medications, targeted therapy, chemotherapy, and immunotherapy.

Radiotherapy

Radiotherapy is often used to treat cases where cancer causes significant pain or threatens to fracture bones. This treatments helps shrink tumours in the bones, alleviate pain, and stabilise areas at risk of breaking. It can be applied locally to specific bones or in a more generalised approach.

Surgery

For patients with severe bone damage or fractures due to metastasis, surgery may be necessary to stabilise the affected bones, relieve pain and restore mobility. There is evidence that the complete removal of a single site of metastatic disease (en-bloc resection) can improve survivorship. An orthopaedic surgeon may use metal rods, screws, or other hardware to reinforce weakened bones, especially in areas like the spine or hips. In some cases, a joint replacement will be used to resect joints whilst maintaining patient function using a specialised tumour prosthesis. In cases of spinal cord compression, surgery may also be performed to relieve pressure on the spinal cord, preventing paralysis and further nerve damage.

If you would like to book an appointment with Mr Guy Morris, head on over to his Top Doctors profile today.