Multiple metastases to the skeletal bones. Treatment of bone metastases: drugs. Treatment of bone metastases with Bondronat

As a rule, the presence of metastases in the bones is a severe complication of a person’s cancer. The process has gone too far and the survival prognosis is extremely unfavorable.

The primary metastatic focus in this case is not amenable to treatment procedures and continues to send its cancer cells to various tissues and organs, including bones. Whether it is possible to cure a person at this stage of cancer, an oncologist decides individually.

Where can metastases come from?

Bone metastases mean damage to bone tissue by cancerous elements. They move from their primary focus along lymphogenous or hematogenous routes. And since the role of musculoskeletal structures in the body of each person is quite large, damage to bones by malignant neoplasms has an extremely negative impact on the overall quality of life.

Most often, this complication accompanies the following forms of cancer:

• pulmonary structures;
• thyroid or mammary gland;
• prostate;
• renal structures.

However, bone metastases can also move from other organs affected by the cancer process. Such secondary lesions are most often diagnosed in the ribs, skull bones, elements of the spinal column, as well as femoral, shoulder or pelvic structures.

Main reasons

In a healthy person, bone cells are continuously renewed. The processes of resorption, as well as bone formation, are carried out due to the constant work of osteoblasts and osteoclasts. It is these elements that are directly responsible for the absorption, formation, or destruction of cartilage and bone tissue.

If there is a malfunction in this well-functioning mechanism, bone metastases are observed, the functioning of the tissue is disrupted, and it becomes metastasized. Healthy elements are replaced by cancerous ones, the mechanisms of interaction between osteoclasts and osteoblasts proceed completely differently, their activities are dissociated.

Among the factors that significantly increase the risk of developing a secondary lesion in the bones, experts point to the following:

• the presence of a branched vascular network around the primary focus;
• localization of the malignant neoplasm - for example, for metastases in the bones, the prognosis is much worse for lung or rectal cancer;
• a significant weakening for a number of reasons of the protective mechanisms of the human body - due to other somatic pathologies, or incorrectly selected antitumor therapy;
• transition of cancer to stages 3B–4 - it is during this period that the appearance of metastases will be an inevitable symptom;
• histological structure of the primary tumor - infiltrative forms of cancer are especially prone to metastasis;
• age category of a cancer patient - in young people, metabolic processes are more intense, therefore relapses of malignant neoplasms occur more often and are more severe.

Whatever the root cause of the formation of bone metastases, their treatment is the task of the oncologist. However, they significantly complicate it.

Main types of metastases

Taking into account the predominant damage to osteoclasts or osteoblasts, it is customary to distinguish two possible types of bone metastasis - osteolytic, with a predominance of tissue destruction processes, and osteoplastic - with local compaction of the area.

However, in practice, pure variants of such lesions are rare; as a rule, mixed types of tumor foci predominate. More often they are diagnosed in structures with abundant blood supply.

Modern diagnostic procedures - for example, CT, MRI - help to establish the presence of metastases, and not any other cells. In order to prevent their occurrence, a specialist recommends comprehensive treatment tactics.

Symptoms

At the early stage of their appearance, metastases do not manifest themselves in any way, but as the pathological process develops, characteristic symptoms form:

• the presence of pain due to metastases in the bones - their appearance is explained by compression of the nerve elements by the ever-increasing size of the secondary cancer focus;
• motor function is also impaired due to the resulting intraosseous pressure;
• frequent pathological fractures - the bone tissue is so thin that the slightest excess load leads to a fracture;
• hypercalcemia - a huge amount of calcium appears in the bloodstream, since its absorption is impaired, the condition is dangerous for the cardiovascular system - heart rhythm disturbances, as well as renal structures - acute failure is provoked;
• local modifications - visually noticeable local swelling or the formation of areas of compaction in the area of ​​the cancerous lesion;
• when cancer cells move into the structures of the spine with the further formation of a secondary tumor in them and its active growth, a compression syndrome complex will be observed - compression of the spinal structures or nerve roots, in some cases provokes complete paralysis of the cancer patient;
• cancer intoxication - lack of appetite, steady weight loss, increasing general weakness, excessive fatigue.

Other signs of metastases include disruptions in the functioning of many systems and organs. For example, severe inhibition of a person, up to confusion and affective disorders. In addition, arrhythmias, hypotension, polyuria, alternating constipation with diarrhea, and intestinal obstruction may be observed.

With timely treatment of a cancer patient and provision of adequate medical care, it is possible to significantly reduce the above symptoms.

Treatment tactics

After confirming the presence of secondary tumor foci in bone structures using laboratory and instrumental diagnostic methods, the specialist will make an individual decision on how to treat metastases in the bones.

Complex antitumor therapy significantly improves the well-being of a cancer patient and also prolongs his life. The main goals of the procedures recommended by the specialist for the treatment of metastases are:

• relief of pain;
• preventing the proliferation of cancerous elements, as well as, if possible, their complete destruction;
• elimination of symptoms of cancer intoxication.

It is imperative to carry out not only measures to treat metastases in the bones, but also the primary tumor site from which these cancer cells came.

Main directions of antitumor therapy:

• The use of cytostatic drugs - chemotherapy. In most cases, it allows you to stop further progression of the pathological process. The main disadvantage of the technique is the large number of side effects.
• Destruction of cancerous foci using x-rays. With a single secondary lesion, the effectiveness of radiation therapy is high, but with numerous lesions it can achieve long-term remission.
• Surgical intervention - if the secondary lesion is single and located in an area accessible for excision, they try to remove it.
• The use of specific pharmacological agents, for example, biosphosphonates. They help restore bone structures. Efficiency increases when medications are combined with chemotherapy and radiation therapy.

But it is unlikely that it will be possible to cure metastases only with the help of traditional medicine recipes. They may well complement basic treatment procedures, but should not replace them.

Related Events

With numerous cancerous lesions of a secondary nature in bone structures, a person begins to experience severe pain. The measures taken by specialists may not bring noticeable results, and the use of adequate pain therapy is required.

To date, a step-by-step scheme for the use of analgesics has been developed - as the intensity of pain impulses increases, medications from increasingly stronger subgroups are recommended.

In addition to analgesics, other drugs are recommended aimed at correcting clinical manifestations - from nausea and vomiting, from diarrhea or constipation, enzymes to improve the absorption of food, vitamin complexes to maintain strength, hepatoprotectors to improve liver function. Their common task is to make a person feel better.

Bone metastases are a secondary cancer phenomenon in which cancer cells migrate to bone tissue and form malignant tumors. Metastasis occurs in the later stages of cancer development and is accompanied by pain, increased calcium levels in the blood plasma, impaired blood flow and fractures.

Causes

The appearance of mts (metastases) in the bones is caused by the spread of cancer cells through the blood vessels from the primary affected organ into the bone tissue, developing into malignant tumors. Most often they migrate from primarily affected thyroid and mammary glands, lungs, kidneys, as well as with Sarcomas, etc. Less common are metastases from the cervix, ovaries, gastrointestinal tract and soft tissues and very rarely from other organs. The most common location of metastases is in bones with abundant blood supply: the bones of the pelvis, arms, legs, chest, skull, bone marrow and ribs. Metastases are often found in the hip, shoulder and knee joints. In case of breast cancer in women, kidney and lung cancer, metastases can go to the xiphoid process, body and manubrium of the sternum, as well as to the ilium, ribs, pelvic, hip bones and shoulder bones.

Tumors disrupt the work of osteoblasts and osteoclasts - large multinucleated cells responsible for regulating the structure and destruction of bone tissue in the process of cellular renewal.

Surgery, pathological fractures and other complications of metastasis can cause chylostasis (stagnation of lymph), which leads to edema. Bone metastases can cause severe pain, such as with melanoma of the spine or a tumor of the ischium that can put pressure on a nerve.

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The main symptoms are caused by hypercalcemia, pathological fractures and spinal compression. There is also an increased temperature due to an active metabolic process and accelerated cell division.

Hypercalcemia

In one third of patients, bone metastases cause hypercalcemia. Calcium, which is part of the bones, is released during bone erosion and enters the blood. Hypercalcemia causes a number of symptoms:

Nervous system:

• Mental instability;
• Lethargy;
• Depression;
• Mental activity disorder.

The cardiovascular system:

• Lack of appetite;
• Nausea;
• Vomit;
• Ulcerative formations.

Urinary system:

• Increased urine production;
• Kidney failure;
• Intoxication.

Pathological fractures

The area of ​​bone affected by metastases becomes fragile due to a malfunction of osteoblasts and osteoclasts, which leads to pathological fractures. Pathological fractures occur when more than half of the outer bone layer is damaged. The fracture may be caused by a minor blow, or there may be no obvious cause at all. Metastatic lesions most often affect the femurs, thoracic and lumbar spine.

Spinal compression

Up to 5% of patients with mts in the spine develop spinal compression, of which in more than half of cases metastases are found in the thoracic spinal region. A growing tumor or bone fragments from a fracture can compress the spinal cord, often leading to irreversible paralysis if the disorder is not detected in time. In the case of already developed paralysis, only one out of ten patients manages to restore motor function.

If the compression was caused by a gradual increase in the tumor, then signs of compression of the spinal cord may not be noticed for a long time, in contrast to the case when a displaced vertebral fragment leads to compression.

Kinds

Osteoblasts and osteoclasts are the main cells involved in normal bone tissue renewal. With metastases in the bones, allostasis is disrupted (the body’s ability to respond to atypical changes and carry out homeostasis - self-regulation), due to which the cells begin to work with a pathological bias, the body cannot cope with the regulation of cellular processes and subtotal damage occurs in the bones.

Osteoblastic

Osteoblasts are the building cells of the skeleton that fill empty areas, produce intercellular substance (matrix) and turn into bone cells (osteocytes). If, due to metastases in the bones, osteoblasts malfunction, then osteosclerotic foci (otherwise sclerotic, i.e. compactions) form in the bones - such disorders are called osteoblastic or blastic, and the formation of compactions is an osteoblastic process.

Osteolytic

Osteolytic disorders are bone disorders in which bone tissue is destroyed. What it is? Osteoclasts break down bone tissue to allow new bone cells to form. Failure in their work leads to an uncontrolled destructive process in which holes are formed in the bones. Bones become brittle and brittle, easily broken and cracked.

Metastases in the bones are rare, leading to one single type of damage, and the manifestation of damage is most often of a mixed type, with signs of both tissue compaction in certain areas and destruction.

Diagnostics

To check for the presence of metastases, there are a number of diagnostic procedures at different stages of the disease:

• Scintigraphy is an examination by injecting radioactive isotopes to produce a two-dimensional image of the affected areas, which appear as white spots. Helps to recognize the presence of metastases at an early stage of their development;
• X-ray - allows you to identify the nature of the lesion, noticeable only in the later stages;
• Computed tomography or magnetic resonance imaging provides a three-dimensional image of the skeleton;
• Biochemical blood test to check the level of calcium in the blood plasma and diagnose hypercalcemia;
• Biopsy allows you to accurately determine the malignancy of neoplasms and make a final diagnosis.

Treatment

Treatment is prescribed by an oncologist based on blood test data, the location of primary and secondary cancers, the stage of destruction and the type of bone damage (osteoblastic and osteolytic are treated differently). The main focus of treatment is to eliminate severe complications to improve the patient's quality of life. If the spine and bones hurt, then they resort to pain relief. The oncologist determines how to treat metastases after all the necessary diagnostic procedures.

Treatment involves the use of medications such as hormonal drugs, bisphosphonates, drugs to enhance immunity, and local procedures such as radiation and surgery. To relieve pain, painkillers are prescribed. Folk remedies include herbal decoctions, poultices, including folk remedies for pain, for example, ointment from comfrey root, which is treated by applying to a sore spot.

Operation

Surgery is performed if severe complications occur, such as a fracture, spinal compression, loss of limb mobility or paralysis. Tumor-like formations are surgically removed. If it is necessary to restore the bone structure, supporting pins and plates are installed. The operation is indicated for a favorable picture of the disease and good general condition of the patient. In other situations, it is recommended to use fixation devices to support the bones.

For osteosynthesis surgery (bone fusion using metal alloys), it is recommended to use titanium to avoid metallosis - oxidation of the metal and penetration of its particles into muscle tissue. If the bone is severely deformed after tumor removal, in some clinics the plastic surgeon performs plastic surgery on the bone or joint replacement.

Chemotherapy

Chemotherapy and radiation therapy are prescribed to destroy cancer cells and prevent further development of metastases. and radiation prepares the patient for surgery and supports it after it. called exposure to ionizing radiation, which destroys cancer cells, or the introduction of drugs strontium-89 or samarium-153. Post-radiation complications require rehabilitation at the end of the course.

Treatment with bisphosphonates

Bisphosphonate drugs provide significant assistance in slowing down secondary cancers in general and bone destruction in particular by suppressing the uncontrolled functioning of osteoblasts and providing a balance between the destructive and regenerative processes.

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*Only upon receipt of data on the patient’s disease, a representative of the clinic will be able to calculate an accurate estimate for treatment.

Bisphosphonate drugs include:

Bisphosphonates containing nitrogen:

• Pamidronate;
• Ibandronate.

Nitrogen-free bisphosphonates:

• Tidronate;
• Clodronate;

Medicines containing nitrogenous compounds have a greater therapeutic effect than bisphosphonates without nitrogen.

Immunotherapy

Enhancing immunity is used to recognize and fight cancer cells. Immune-boosting drugs increase the amount of immune antibodies and increase their ability to recognize and kill cancer cells.

How long do people live with bone metastases?

Life expectancy for bone metastases directly depends on the location of the foci from which the cancer cells were transferred. In general, a time corridor for life expectancy has been determined for each type of cancer, but this period is not a death sentence, since in some cases the situation depends on the presence and degree of complications and it is possible to stop the destructive processes.

Prevention

Metastases to the bone are less dangerous than metastases to the organs of the sternum and abdominal cavity. It is recommended to reduce the load on the affected areas of the skeleton as much as possible, use crutches depending on the location of the metastases, lie down more often, wear a support corset or head holder, and not lift heavy objects. Nutrition should include foods that are good for bones and general immunity.

Is it possible to cure bone metastases? Early detection of metastases and strict adherence to the treatment and recommendations prescribed by the doctor increases the chances of defeating the disease and saving the patient’s life.

Video: Metastases in bones

Anonymous reviews

Anonymously. A friend was first diagnosed with breast cancer, then with lytic metastases. The doctor told her that they live a long time with MTS, her friend goes every month to take Zometa and overall feels good.

Anonymously. The doctor also told me that the survival rate for mts in the bones is higher than if it is in the organs. I had two chemotherapy treatments, now I take bisphosphonates regularly and continue to live a full life, so there is no need to despair.

Anonymously. The grandmother lived with metastases for 10 and a half years, but there was pain and several fractures, she was active and did not sit still. She took morphine for pain.

Cancer is one of the most terrible and dangerous diseases threatening humanity. Oncological pathologies are numerous; they develop suddenly, sometimes without any previous signs. It is also important to remember that cancer at certain stages can spread throughout the body, which is how metastases appear in the bones.

In such situations, we must not forget that the skeletal system plays a vital role in the human body. Bones are responsible not only for musculoskeletal functions, they are the focus of the accumulation of minerals, etc. Metastasis to bone structures is one of the most severe forms of cancer; in order to resist pathology, you need to know as much as possible about it.

To answer this question, you need to understand the nuances of what the process of metastasis itself is.

So, the term metastasis in medicine refers to a secondary tumor that originates from the primary focus of a malignant tumor. Metastases can spread throughout the body, affecting nearby or distant organs, as well as entire systems, including bone structures.

It is important to understand that bone metastases are precisely a secondary type of tumor, since a primary tumor is one that initially appeared and grew in the bone. Metastases enter bone structures and affect them due to the spread of malignant blood cells throughout the body, which circulate through the lymphatic or bloodstream (lymph and blood flow).

The process of metastasis occurs mainly at the last and most severe, that is, the fourth stage of cancer. Moreover, according to statistics, about 80% of all cases of bone metastasis occur due to breast cancer, prostate cancer, lung cancer, etc.

In other words, it is the listed types of oncological pathology that in most cases give metastases, which subsequently affect the skeletal system and lead to bone cancer.

Causes and types

As mentioned above, the main cause of metastasis and secondary bone cancer lies in the oncology of any organs. In most cases, the development of pathology occurs with cancer of the following localization:

• for breast cancer;
• thyroid gland;
• lungs;
• kidney;
• with an increased likelihood of bone metastases in prostate cancer;
• organs of the gastrointestinal tract, mainly the stomach;
• ovaries, etc.

These types of cancer are more likely than others to metastasize to the bones, but this does not mean that other types of cancer cannot cause bone cancer.

In addition, some scientists argue that metastases do not affect all bones. The formation of neoplasms occurs mainly in large bone structures and hollow bones. In general, a comparative description can be given by comparing tumor formation and the likelihood of metastasis. This characteristic is as follows:

• With breast cancer, that is, mammary glands, metastasis more often occurs to the bone structures of the spinal column.
• Metastases in the ribs, hands, feet, as well as in the bones of the skull appear mainly in global oncological lesions in the late stages of the oncological process.
• Another “favorite” site for metastases is the bones of the ace and thighs. This is explained by the fact that the bone structures in these areas of the skeleton are very massive.

If we talk about the causes and types of bone metastasis, we cannot fail to mention the division of bone metastases into two main types:

1. Osteoblastic metastases - their characteristic feature is the formation of compactions directly on the surface of bone structures.
2. Osteolytic metastases - this case is fundamentally different from the previous one, since the bone tissue and the bone itself are destroyed, the pathological process occurs from the inside.

Taking into account the two types of metastases described, one more cause of bone cancer can be identified. To do this, you need to know that in the body of a healthy person bone tissue is continuously renewed, processes of resorption, bone formation, and remodeling occur. The functioning of renewal processes depends on the activity of certain cellular units - osteoclasts and osteoblasts.

In patients with metastases, pathological cells penetrate into the cellular structure of the bones, and the work of osteoblasts and osteoclasts is disrupted. As a result, the normal regulation of the processes of formation, absorption and destruction of bone tissue is disrupted, healthy cells are replaced by pathogenic ones. A particularly severe pathological process is diagnosed when metastases enter the bone marrow.

A separate reason for the development of oncology, which is important to mention, is bone fractures. Most doctors agree on the theory that fracture sites, even after decades, are more likely to become sites of cancerous tumors. According to this theory, the chance of bone metastases is higher in the place where the fracture was once localized.

In addition, in addition to the increased likelihood of large bone metastases, bone structures with an abundant blood supply also fall into this category.

Symptoms and characteristic signs

The process of formation of bone metastases has different symptoms; in some cases, the clinical picture depends on where exactly the tumor is localized and growing. The point is that in some cases, atypical clinical signs characteristic of the manifestation of cancer in certain areas of the skeleton appear in the general symptoms.

But before moving on to such features and special cases, it is worth considering the general clinical picture in patients with metastases. To begin with, it is worth saying that the first stages of the development of metastases in the bones are completely asymptomatic. The only symptom, which also does not appear in everyone, is increased fatigue and general malaise. As the pathology develops and the tumor grows, the following symptoms appear:

• Pain with bone metastases is the main and most striking symptom, which is present in 98% of cases. The pain syndrome is localized mainly in the place where the malignant neoplasm was localized. The nature and specificity of the pain is constant, and tends to intensify with physical activity, movement, and also during night sleep with muscle relaxation.
• With the development of the tumor process, swelling appears. The swelling also has a clear localization; it surrounds the tumor. This means that if we are talking about a hip tumor in the hip joint, there will be swelling around this area. The exception is lesions of deep bone structures, in which case the swelling may be hidden.
• Distortion or deformation of the affected area. In this case, the tumor grows and protrudes, forming a kind of lump or lump. The size of the deformed area depends on the size of the neoplasm itself.

The general clinical picture also contains signs of causeless weight loss, constant low-grade fever, lethargy, drowsiness, loss of strength, loss of appetite and increased sweating. All these clinical signs are invariably present at the stages of metastasis, because in this case we have to talk about severe progression of oncology.
In addition, metastasis of bone structures is accompanied by atypical symptoms, the following disorders occur:

• Pathological fractures - a clinical sign comes into force at that stage of the oncological process when more than 50% of the patient’s cortical layer of bone structures is destroyed. In such cases, bones become brittle and joints become fragile. The spine, pelvic bones, and central sections of the tubular bones suffer the most. A fracture can occur from a minor blow or even from an unsuccessful movement;
• Spinal cord compression – manifestations of compression mainly affect the thoracic spine. Less often it is the lumbosacral region and in only 10% of cases it is the cervical region. In addition to painful sensations, compression is accompanied by a gradual loss of musculoskeletal functions, paralysis of the limbs and areas of the body that are controlled by the nerves in the corresponding part of the spine. There is a violation of blood circulation, as well as the functioning of the nervous system;
• Hypercalcemia - develops due to excessive activity of osteoclasts, due to which calcium is “washed out” into the blood from damaged bones, which negatively affects kidney function. As a result, the patient develops polyuria, as one of the complications, and serious disorders of various body functions begin. As a result, disturbances occur in the functioning of the nervous and cardiovascular systems, kidneys, and gastrointestinal tract organs.

How to determine?

If appropriate symptoms appear and there is suspicion of the formation of metastases in the bones, it is necessary to consult an oncologist. To confirm the diagnosis, the specialist must prescribe a number of diagnostic measures to the patient.

As part of the diagnostic examination, the following are required:

How to treat?

Bone metastases are a disappointing diagnosis, but they are not a reason to refuse treatment. Even if therapy does not guarantee recovery, adequate treatment of bone metastases significantly alleviates symptoms, improves the patient’s quality of life, and also increases life expectancy.

In general, for bone metastases, the treatment regimen involves an integrated approach, which includes:

Treatment requires the mandatory involvement of an oncologist. Resorting to folk remedies to combat cancer is highly discouraged, since such exposure can only aggravate the patient’s condition and provoke the progression of the disease.

How long do they live?

Bone metastases are a disappointing diagnosis, because in this case we are talking about a severe stage of cancer progression. At the same time, it is very difficult to predict life expectancy, because it is necessary to take into account a lot of different factors.

Despite this, most doctors agree that with such a diagnosis, a person lives from 3 months to a year and a half. But even such figures should not be demoralizing, because modern methods of cancer treatment, provided they are timely, the desire to live and a number of individual factors can increase life expectancy. In addition, there is always room for a miracle and the onset of remission.

Metastases of malignant tumors can appear in any organ. They are caused by cancer cells carried through the bloodstream. Cancer metastases to the bone are a fairly common occurrence in stage 4 cancer of various organs. However, at the present stage of development of oncology, specialists no longer shrug their shoulders helplessly, because quite effective methods for treating bone metastases have appeared in their arsenal.

How are bone metastases diagnosed and treated abroad?

The choice of treatment for bone metastases depends on the location of the primary site, which may be prostate cancer, breast cancer, or liver cancer. It is very important to find out which bones are affected by cancer and what structural changes have occurred in the bones. The choice of method is also influenced by the general condition of the patient, as well as the treatment he previously received.

In oncology, the method of skeletal scintigraphy, or radionuclide bone imaging, is usually used. To do this, a special radiopharmaceutical containing a radioisotope (radiomarker) is introduced into the patient’s body, which is accumulated to varying degrees by healthy tissues and malignant tumor cells. Radiation from the tumor focus, accordingly, will also be more intense. It is recorded by modern 3-dimensional scanners, which provide a clear picture of bone metastases on the screen.

To diagnose bone metastases, the following are also used:

• modern tomography methods - CTG, MRI, PET;
• diagnostic punctures with biopsy and histological identification;
• blood test and urine test to determine the level of calcium, alkaline phosphatase.

All internal organs are also examined to identify the primary tumor site.

Such methods are widely and successfully used in oncology centers of clinics in developed countries, where the following is performed:

• removal of the metastatic node itself;
• blocking further spread of cancer cells;
• restoration of bone destroyed by metastasis, or prosthetics;
• restoration of function, pain relief.

This treatment is carried out in parallel with the treatment of the primary cancer, and it is also combined and innovative, like cancer treatment abroad. Therefore, bone metastases are not a death sentence for the patient; they can and should be treated where such treatment exists - in Israel, Germany and other European countries.

Features of the treatment of bone metastases in Israel

Typically, a combination of several methods is used to treat bone metastases, this can be:

• chemotherapy;
• immunotherapy;
• hormone therapy;
• administration of radioactive drugs;
• radiofrequency amputation;
• radiation therapy;
• surgery;
• medicinal treatment.

Radiosurgical removal of bone metastases

Where and how do bone metastases form?

Cancer tissue in 4th stage has a rather loose structure. Its cells enter the washed tissue fluid, from there into the lymph and blood, and, circulating throughout the body, settle in various organs and bones.

The branching of the vascular system of bones and the peculiarity of the structure of bone tissue contribute to the settling of cancer cells in it and the development of secondary tumor nodes. This process occurs gradually, and its speed depends on the degree of malignancy of the cancer.

The most common objects of metastasis are:

• spine and tubular bones;
• pelvic bones, ribs, sternum;
• skull bones.

Cancer metastasizes to the spine from almost any organ:

• to the cervical region – thyroid cancer and breast cancer,
• to the thoracic region – lung cancer, breast cancer, esophageal cancer,
• in the lumbar – prostate cancer, uterine cancer, bladder cancer, kidney cancer;
• into long tubular bones - prostate cancer, cervical cancer, kidney cancer metastasizes;
• in the pelvic bones - metastases of prostate cancer, bladder cancer, testicular cancer, and uterine cancer are more common;
• into the sternum and ribs - gives metastases to lung cancer, breast cancer;
• in the skull bones - Oral cavity cancer, thyroid cancer, and laryngeal cancer metastasize more often.

In principle, the location of a bone metastasis can be completely unexpected and distant from the organ affected by cancer.

What symptoms can be used to suspect bone metastases?

You cannot rely on clinical symptoms alone, because at the beginning of the development of metastasis they will practically not differ from the symptoms of osteochondrosis and polyarthritis. Such symptoms occur quite often in the population, especially in old age, and, unfortunately, they are not given due attention.

When significant bone destruction occurs from a metastatic node, late symptoms specific to bone metastases appear:

The more severe the bone damage, the more difficult and lengthy the treatment of metastases. Therefore, in oncology there is a rule of mandatory examination of the skeletal system for any malignant tumor. On the other hand, pain in the spine, joints, or in any part of the skeleton is an indication for a tomographic examination.

Do patients feel pain with bone metastases?

The most common complication in the presence of bone metastases is pain. Usually, when pain increases, the patient is prescribed drug therapy, including narcotic analgesics.

You should not be afraid of prescribing these drugs, since pain is always very exhausting and prevents the body from fighting the disease. Even if the pain is moderate, it cannot be tolerated!

Bone metastases: life expectancy

Metastatic process in the bones indicates the fourth stage of cancer. It is very difficult to talk about a favorable prognosis. All treatment is aimed at relieving symptomatic pain in order to improve the patient's quality of life. Life expectancy for any stage IV cancer does not exceed a year.

What is the cost of treating bone metastases abroad?

When treating bone metastases abroad, treatment methods are selected individually for each patient, depending on the location, size and location of the lesions, their number, and the degree of bone destruction.

For one patient, it is enough to remove the node; for another, in addition, reconstructive surgery or prosthetics is needed. Similar treatment methods will differ depending on the country and on the pricing policy for medical services. It is well known that prices for treatment in Israel are significantly lower than in Western countries, therefore treatment of bone metastases in Israel is the most affordable.

Approximate cost of treating bone metastases abroad:

You can find out what the cost of treatment for bone metastases will be in your case on our website. To do this, fill out contact form , and the doctor coordinator will definitely contact you and provide the necessary information.

Cancer that has spread to the bone tissue indicates bone metastases,treatment which depends on the organ with the primary lesion and the circumstances of the progression of the cancer process.

Bone metastases are not made up of bone cells, but rather from abnormal tissue from the primary tumor. For example, lung cancer that has spread to the bones is made up of lung cancer cells. In this regard, each type of metastasis requires special treatment.

Bones are a common site for tumors of the breast, kidneys, lungs, prostate, and thyroid gland. Establishing the type of primary tumor formation and the method of damage to bone tissue is important for adequate treatment.

Methods of spreading metastases

Cancer cells are able to penetrate bone tissue in two ways:

1. First, the tumor eats away at areas of the bone, creating holes called “osteolytic lesions.” This process can make bones brittle and weak, making them easy to crack or break.
2. A malignant tumor stimulates the growth of new abnormal bone tissue. These regions are called “osteoclasts” or “osteoblasts,” depending on the specific type of formation. They are painful, weak and unstable, prone to frequent ruptures.

Metastases in the bones: diagnosis

To select the best therapeutic method, the exact location, type of malignant process, etc. must be determined. For this, the following diagnostic tests are used:

• Bone scan

This method allows you to detect faster than x-rays bone metastases. The scan shows the patient's entire skeleton and allows the doctor to monitor the condition of all bones in the body, including the response to treatment.

• CT scan

It is used for a detailed study of the spread of a malignant process in bone structures. The scanner rotates around the body of a cancer patient, depicting the state of the body from different angles.

• Laboratory tests

Metastases in bones can make themselves felt by a number of substances that specialists can detect in the blood. Calcium and the enzyme alkaline phosphatase are the main elements that indicate the presence of a pathological condition.

• Magnetic resonance imaging

It uses radio waves to create a cross-section of the body. This type of diagnosis is especially useful when studying the spinal cord and joints.

How are bone metastases treated?

For bone metastases, the following treatment options are available:

Use of bisphosphonates

These drugs slow down the progression of pathological destruction of bone tissue and the development of new formations caused by the metastatic process. The drugs are capable of:

• reduce the risk of fractures;
• reduce pain in bone structures;
• regulate calcium levels in the blood.

There are types of bisphosphonates such as Aredia (pamidronate) and Aredia (zoledronate). Typically, they are administered intravenously every 3-4 weeks. Oral forms are poorly absorbed and may irritate the gastrointestinal tract.

Bisphosphonates are primarily used in people with metastatic breast cancer, prostate cancer, and multiple myeloma.

Taking the drug Denosumab

It is used instead of bisphosphonates and is injected under the skin every four weeks. The remedy can delay problems such as bone fractures.

Radiation therapy

The method injures or destroys metastatic cells in the bones. It is carried out once a day for two to three weeks. There should be 10 procedures in total. Radiation is also used to prevent bone destruction and spinal cord compression.

Radiopharmaceutical therapy

This is a different type of radiation that involves injecting chemicals such as strontium-89 or samarium-153 into a vein. The substance is attracted to areas containing cancerous growths in the bones. In this way, active cancer cells are destroyed. This type of treatment is especially effective when many bones are affected by the malignant process.

Chemotherapy and hormone therapy

A situation in which bone metastases, provides treatment, which, first of all, should be based on an integrated therapeutic approach. Only in this way can the disease be overcome and the individual chances of survival improved for each individual patient.