Bone metastasis

Cancer is a disease that usually does not show symptoms until it is in an advanced state and generally having metastasized. In fact, sometimes the diagnosis comes when they start to generate symptoms and the patient decides to go to the doctor. The pain caused by a bone metastasis is one of those symptoms. Initially it can be intermittent, disappearing with the movement, but there comes a time when it is continuous and sometimes worsens with the activity.

However, it should be borne in mind that bone pain can be a symptom of many other diseases, so it will be necessary to perform the corresponding clinical study to establish a differential diagnosis.

The sooner the bone metastasis is detected and its treatment started, the better possible complications that, depending on the affected bone, could range from a fracture to compression of the spinal cord. In the latter case, depending on the height of the spine in which the metastasis is located, different functions of the organism can be affected and even cause paralysis.

Another complication usually associated with bone metastases is the existence of a high concentration of calcium in the blood (hypercalcemia), which can cause nausea, constipation, sleep disturbances, a feeling of weakness, thirst, loss of appetite and a constant need to urinate that can lead to a dehydration box.

Bone Metastases Treatment

Although chemotherapy treatments also act on bone metastases, the truth is that they are not curable, but they must be treated properly and specifically in order to reduce pain, maintain bone functionality, prevent decalcification and even improve bone density to prevent possible bills or other complications. Treatment will depend on the location of the metastasis and the primary cancer that caused it.

It should be noted in this regard, that currently there are systemic cancer treatments that are specific for tumors that have spread to the bones, although some of them are still in the experimental phase. This is the case, for example of immunotherapy, which is about stimulating the immune system to eliminate cancer cells, for which cytokines, monoclonal antibodies or so-called anti-tumor vaccines are used.

Radiopharmaceuticals are also available, medicines that have a radioactive component and are administered intravenously, so that they reach the bone and act specifically on cancer cells, causing a reduction in bone metastasis and the pain it causes.

Precisely, the first therapeutic objective in the presence of a bone metastasis is pain control, which represents an important improvement in the patient’s quality of life. For this there are two ways of treatment. The first is the use of drugs, according to the clinical guidelines that have been developed for this purpose, so that it will always start from the less potent and will change in ascending order when they stop fulfilling their function. On the other hand, radiation therapy also helps reduce and control pain. It is applied directly to the metastasis, protecting the adjacent areas and organs by masks made to measure for each patient, with a material that does not let radiation through.

Another treatment that is applied specifically to the existence of a bone metastasis is that which is carried out with bisphosphontase, some medications indicated in the treatment of osteoporosis, whose most important effect is the remineralization of bone, in order to, in addition to placate the pain, reduce the risk of a possible bone fracture by strengthening the bone and, at the same time, control hypercalcemia, if it has occurred. However, if the loss of bone density of the metastasis is very high, sometimes a direct injection into the bone of a substance called bone cement is used, so that it hardens and fracture can be avoided (usually used when metastases affect the longer bones or the spine.

Finally, it should be noted that surgery is also a therapeutic option, always depending on the general condition of the patient, either to treat a fracture or when there is pressure on the spinal cord, with the risk that it may cause paralysis.


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