Survival rates for people with bone metastases vary greatly by cancer type and stage. Your general health condition and the type of treatment you received for the primary cancer are additional factors. Discuss your particular situation with your doctor. Remember that survival rates are averages gathered from large numbers of people.
Also, survival data may reflect statistics from a period before the most recent treatment advances. A large-scale study of the 10 most common cancers with bone metastasis found:.
Here are some typical figures from a study of common cancers and bone metastasis:. Your treatment plan will depend on:. Specific drugs that target bones are an important part of therapy and a developing research area. A breast cancer study reported a lower risk of bone complications for people who started treatment within 6 months of a bone metastasis diagnosis.
As we learn more about the mechanisms of how cancer cells invade and disrupt bones, scientists develop new ways of targeting and slowing these cancer cells. Note that most cancer treatments have side effects. Discuss these with your doctors and evaluate the benefits versus risks for your treatment. Ask your doctors about new developments in the field that may help you.
Drug development for cancer is a fast-moving research area. The medical literature has articles on new possibilities under development and testing. For example, the use of nanoparticles has the promise of enhancing both current drugs and new drugs under development. Nanoparticles can be used to deliver drugs to the metastasis site with fewer side effects.
You may be eligible for a clinical trial. Clinical trials test out new drugs, experiment with new treatments, and compare the outcome of existing treatment combinations. Journal of Urology ; Long-term efficacy and safety of zoledronic acid in the treatment of skeletal metastases in patients with nonsmall cell lung carcinoma and other solid tumors: A randomized, Phase III, double-blind, placebo-controlled trial.
Cancer ; 12 Long-term pamidronate treatment of advanced multiple myeloma patients reduces skeletal events. Myeloma Aredia Study Group. Journal of Clincal Oncology ;16 2 Zoledronic acid versus pamidronate in the treatment of skeletal metastases in patients with breast cancer or osteolytic lesions of multiple myeloma: a phase III, double-blind, comparative trial.
Cancer J. Zoledronic acid delays the onset of skeletal-related events and progression of skeletal disease in patients with advanced renal cell carcinoma. Cancer ; 98 5 Oral clodronate for adjuvant treatment of operable breast cancer: Results of a randomized, double-blind, placebo-controlled multicenter trial. JCO ;22 14S , Abstract Effects of atrasentan on disease progression and biological markers in men with metastatic hormone-refractory prostate cancer: Phase 3 study.
Impact of atrasentan on prostate-specific outcomes with hormone refractory prostate cancer patients. All Rights Reserved. Treatment and Prevention of Bone Metastases The management for bone metastases depends largely on the degree of bone damage once the metastases are diagnosed. Moderate to Severe Pain : Patients with moderate to severe pain who have not responded to the first step should receive an opioid. These medications may include codeine, hydrocodone, dilhydrocodiene, oxycodone, propoxyphene, and tramadol.
Severe Pain : Patients with severe pain or patients whose pain has not been relieved by the previous recommendations will usually receive a stronger opioid. Opioids for severe pain may include morphine, oxycodone, hydromorphone, methadone, levophanol, or fentanyl.
A non-opioid medication such as aspirin, acetaminophen, or ibuprofen may be added in some cases. Bisphosphonate Drugs in the Prevention and Treatment of Bone Metastases Bisphosphonate drugs can effectively prevent loss of bone that occurs from metastatic lesions, reduce the risk of fractures, and decrease pain. Bisphosphonates have been shown to prevent or delay bone destruction and related pain in clinical trials involving patients with bone metastases related to: Breast cancer Prostate cancer Lung cancer Multiple myeloma Renal cell carcinoma Breast cancer: Bisphosphonate therapy has been shown to prevent or delay bone destruction and related pain in women with breast cancer that has spread to the bone.
Surgery in the Treatment of Bone Metastases When there is an immediate or significant risk of fracture, surgery may be necessary to stabilize the weakened bone. Strategies to Improve Treatment and Prevention of Bone Metastases The development of more effective cancer treatments requires that new and innovative therapies be evaluated with cancer patients.
References 1 Oncology Nursing Society. From the news hub. Asha Karippot. Radiation is often used as part of the treatment, sometimes with a type of medicine called a steroid or corticosteroid.
The radiation often is started right away, within the first 12 to 24 hours. If the spinal cord is already showing signs of damage such as weakness in the legs , immediate surgery followed by radiation may be the best treatment.
This may allow a patient to walk and function better than if they get radiation alone. People with very advanced cancer or other serious medical problems may not be able to have this kind of surgery. When cancer spreads to the bones, too much calcium from the bones can be released into the bloodstream. This is called hypercalcemia. Treatment includes giving large amounts of intravenous IV fluids to protect the affected kidneys and medicines such as bisphosphonate drugs see below to bring blood calcium levels down quickly.
Once the calcium level is back to normal, treating the cancer can help keep the calcium level from getting too high again.
The drugs used most often for treating bone problems in people with bone metastases are the bisphosphonate drugs pamidronate Aredia and zoledronic acid Zometa and the drug denosumab Xgeva, Prolia. These drugs are given intravenously IV or into a vein or subcutaneously under the skin. Most patients are treated once a month at first, but may be able to be treated less often later on if they are doing well. Treatment with one of these drugs can help prevent further bone damage and events related to weakened bones such as fractures, hypercalcemia, and spinal cord compression.
These treatments can have a rare but serious side effect called osteonecrosis of the jaw ONJ. Patients complain of pain and doctors find that part of the jawbone has died. The jawbone can also become infected.
Below is a brief overview of systemic whole body therapies. Bisphosphonates and denosumab are drugs that help strengthen your bones and help prevent fractures by stopping the loss of bone mass. These can taken by mouth or by injection into a vein or underneath the skin. A rare side effect of these drugs is a problem with the bone in the jaw.
Good dental hygiene is important in preventing this. A dental check is recommended before you start this medication. These treatments help to slow the growth or reduce the size of cancerous deposits in the bones. They work by blocking the production or the effect of hormones that would otherwise help cancer cells to grow.
They only work if your cancer was oestrogen receptor ER positive. There are a number of different hormone-blocking medications. Tamoxifen is suitable for most women regardless of whether or not they have gone through menopause. Another option is a tablet called an aromatase inhibitor.
This medication only works after menopause. Other options to reduce hormone levels include blocking the function of the ovaries by medicine, radiotherapy or surgery. These are only helpful in controlling cancer in women who have not yet gone through menopause. Chemotherapy is the use of medicines drugs to kill cancer cells. These can be given by mouth or by injection into the vein.
A medical oncologist is a cancer specialist who can advise you on what type and schedule of chemotherapy drugs may work for you. Although current treatments for bone metastases are unable to completely remove all cancer cells, many women with bone metastases can live for many years with extremely good quality of life.
The effect of bone metastasis on your prognosis is individual and depends on what type of cancer you have, where it has spread to and how you respond to various treatments.
The main aim of any treatment is to control pain and other symptoms so you can enjoy your day-to- day activities as much as possible. This site contains information, data, documents, policies, procedures, guidelines, images and general health promotion material pages prepared by Westmead Breast Cancer Institute "the Information" for and on behalf of the Western Sydney Local Health District.
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Bone Metastasis. What is a metastasis? What are the symptoms of bone metastases? Pain Pain is the most common symptom of bone metastases. Fracture broken bone Cancer deposits can weaken a bone and this can cause the bone to break fracture. Spinal cord compression Cancer in the bones of the spine called the vertebrae can cause pressure on the nerves that travel through the spinal cord.
Symptoms of spinal cord compression can include: persistent pain in the back that may be worse with coughing, sneezing or straining numbness or weakness in the legs, causing difficulty with walking difficulty controlling the bladder or the bowel paralysis rarely.
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