What Is Bone Metastasis?

Osseous metastasis is a disease that mainly manifests bone damage and pain caused by the hematogenous metastasis of certain malignant tumors other than bone tissue. Breast cancer is the cancer most prone to bone metastases. Malignant tumors that are prone to bone metastasis are breast cancer, lung cancer, kidney cancer, rectal cancer, pancreatic cancer, gastric cancer, colon cancer, ovarian cancer, and other common primary cancers of bone metastasis are prostate cancer. Bone metastases occur most frequently in the spine, followed by long bones of the pelvis and lower extremities, and knee and elbow joints far less common. Bone metastases can cause severe pain and fractures. If the local lesion has compression symptoms, surgery and radiotherapy can be used to improve the symptoms, but the effect is poor. Combined traditional Chinese and western medicine can be used to treat bone metastases.

Basic Information

Visiting department

Oncology, Orthopedics

Common locations

skeleton

Common causes

Malignant tumor metastasizes to bone tissue

Common symptoms

Severe pain, fracture

Causes of bone metastases and common diseases

After the tumor cells reach the bone marrow with the blood flow, they interact with osteoblasts, osteoclasts and bone stromal cells to destroy the bone tissue and release a variety of growth factors stored in the bone tissue. . Bone metastasis can be divided into three types: osteolytic, osteogenic and mixed. Generally speaking, breast cancer and lung cancer metastasis is mainly osteolytic metastasis, while prostate cancer is mainly osteogenic metastasis.

Bone metastases

1. X-ray inspection

This method is the most commonly used method for bone examination, but this method is difficult to diagnose bone metastases early. Generally, only when the bone is damaged by the tumor more than 1 cm and the bone decalcification reaches 50% to 70%, Only plain radiographs can be used to observe signs of localized bone loss, blurred or disappeared trabeculae.

2. Bone metastasis

Early symptoms are generally absent, and bone isotope scans can reveal diseased bones throughout the body.

3. Bone metastases that occur in the spine can be examined by MRI and CT reconstruction

4.PET (Positron Emission Tomography) Inspection

This inspection method can observe small lesions that are difficult to find by ordinary imaging methods.

5. Bone puncture biopsy

This method can clearly diagnose the pathological type of bone metastatic cancer and is of great significance in guiding the treatment of the disease.

Differential diagnosis of bone metastases

Bone metastases occur in different parts and cause different clinical manifestations, with bone damage and pain as the main manifestations. Chest pain caused by rib metastases is mostly pain in the chest wall with localized tender points. Spinal cord metastases cause pain in the center or lesion of the back and compression symptoms of the spinal cord, while bone metastases in the limbs or trunk cause localized pain and radiation pain in the site.

Bone metastasis treatment principles

Comprehensive treatment should be used for bone metastases, including surgery, radiotherapy, bisphosphonates, systemic treatment of the primary disease (systemic chemotherapy and molecular targeted therapy), pain treatment, nutrition support treatment, etc.

Surgical treatment

The purpose of bone metastases is to prolong life, relieve symptoms, improve quality of life, prevent or manage pathological fractures, and relieve nerve compression, including minimally invasive and vertebroplasty treatment.

2. In vitro radiotherapy

It is a more traditional treatment with better analgesic effect and can effectively prevent paraplegia in patients with severe vertebral bone metastasis, but it has no repairing effect on damaged bone.

3.Bisphosphonate

Bisphosphonates have become an important supportive treatment method by delaying bone destruction, reducing or delaying the occurrence of bone-related events, and improving the quality of life of patients.

4. Cancer Pain Treatment

Bone metastases are advanced cancers, and 50% to 90% of patients have pain, 50% of them are severe pain, and 30% are intolerable severe pain. Pain treatment for patients with metastatic tumors includes radiotherapy, chemotherapy, surgical palliative surgery, and the use of painkillers that follow the three-step treatment principle. Some patients may consider the application of traditional Chinese medicine for analgesic treatment.