Can cancer spread to your bones? (Bone Metastasis) Let's talk about this!

You may have heard of someone with cancer who later developed bone pain or weak bones. You may have experienced this yourself. This is actually caused by cancer cells spreading from one part of the body to the bones. We call this bone metastasis . Although this is a serious condition, don't panic. The most important thing is to be aware of it and manage it properly.

What is Bone Metastasis? Let's understand it simply.

Simply put, bone metastasis is when cancer cells that started somewhere else in your body (such as the breast, lung, or prostate) travel through your bloodstream to your bones and begin to grow there. This is one of the symptoms of metastatic cancer .

The most important thing to know is that this is not primary bone cancer. This is cancer that has spread to the bones from somewhere else.

Unfortunately, there is no cure for this condition. However, there are many treatments available to control symptoms and slow the progression of the condition. Another factor is that people are living longer with cancer than ever before, so bone metastasis is becoming more common. One study showed that the incidence of bone metastasis increased from 3% in the first year after cancer diagnosis to 8% 10 years later.

What are the symptoms of this? See if you have these too

The most common symptom is bone pain . It can feel like something is being pulled or heaviness. The pain can be worse at night, especially at night. Sometimes it can be sharp, stabbing, or sharp.

Bone metastasis can cause other complications. There are also specific symptoms related to it:

• Bone Fractures: This condition makes your bones very fragile. In other words, you can break a bone without a major fall. It can affect any bone in your body. But it most commonly affects the spine, ribs, pelvis, humerus, femur, and skull. The pain when a bone breaks is very sharp and severe. If you break an arm or leg, you won't be able to move it.
• Hypercalcemia: This is when your blood calcium levels become too high. Symptoms include dizziness, constipation, loss of appetite, nausea, and vomiting.
• Spinal Cord Compression: If a tumor that has spread and is pressing on your spinal cord, you may experience back pain, weakness or numbness in your arms and legs, and urinary incontinence. This is an emergency .

Why is this happening? What is the reason?

This condition occurs when cells from cancerous tumors break off, enter your bloodstream, travel through it, and then travel to your bones. Once there, those cancer cells begin a process that experts call the "vicious cycle of bone metastasis."

To understand this cycle, it helps to know a little about how your bone cells work. There are two main types of cells in our bones: osteoblasts and osteoclasts .

• Osteoblasts are cells that make new bone.
• Osteoclasts are cells that dissolve, break down, and remove old, damaged bone cells.

Normally, these two types of cells work together to maintain a balance between the production of new bone cells and the replacement of old bone cells. But when cancer gets into the bones, this process goes awry. Here's what happens:

• If osteoblasts make too many new bone cells, your bone will build up too much, and you will develop areas of abnormal bone formation. Your doctor may call these areas osteosclerotic lesions or osteoblastic lesions . These areas may look hard from the outside, but they are very fragile, like a thin layer of ice on the bank of a river. They can break and crumble easily.
• When osteoclasts break down bone cells faster than normal, substances released by your bone cells can cause tiny holes in your bone. If you look at it under a microscope, it can look like someone drilled holes in your bone. Your doctor calls these holes osteolytic lesions . These lesions make your bones more fragile and weak. This increases your risk of breaking a bone.

Research has shown that there is a link between certain types of bone cells and certain types of metastatic cancer. For example, 70% to 85% of bone metastases from prostate cancer are osteogenic, meaning they are caused by osteoblasts making too much bone. However, 75% of metastases from breast cancer are osteolytic, meaning they are caused by bone cells breaking down too quickly.

How do you recognize this?

Your doctor will do several different imaging tests to diagnose this condition. They may also do blood tests or urine tests to look for substances that indicate bone damage. Imaging tests may include:

• Bone scan
• CT scan (Computed tomography - CT scan)
• MRI scan (Magnetic resonance imaging - MRI scan)
• PET scan (Positron emission tomography - PET scan)
• X-ray

These tests can accurately determine the condition of your bones, whether cancer cells have spread, and how far they have spread.

What are the treatments?

Unfortunately, there is no cure for bone metastasis. However, there are medications and treatments that can help reduce pain and control the progression of the condition . These treatments can go a long way in improving your quality of life.

Here are some of the main treatment methods:

• Bisphosphonates: These drugs (e.g., Pamidronate, Zoledronic acid (Zometa®)) strengthen your bones, reduce the amount of calcium in your blood, and reduce the risk of developing hypercalcemia.
• Chemotherapy or hormone therapy: Your doctor may prescribe this treatment if you have more than one site of cancer cells spreading (metastases) to your bones.
• Monoclonal antibody therapy: Drugs such as Denosumab (Prolia® or Xgeva®) are given to reduce the risk of bone fractures.
• Radiation therapy: If you have pain from a tumor in one of your bones, radiation therapy may be given to treat that pain. It can also help with pain caused by spinal cord compression. Your doctor may also give you corticosteroids along with radiation therapy.
• Kyphoplasty: This is a treatment for spinal compression fractures.
• Surgery: Your doctor may recommend surgery to strengthen fragile bones or remove a cancerous tumor.

Remember, your doctor will decide the best treatment for you, so talk to him/her about this carefully.

What happens if left untreated?

If bone metastasis is left untreated, complications such as hypercalcemia can occur. If left untreated, this can lead to a coma. Also, you may not be able to walk or do your work due to bone fractures. Severe bone pain can reduce your ability to enjoy life. Most importantly, spinal cord compression can lead to paralysis if left untreated. So, do not ignore the symptoms.

What to expect if you have bone metastasis?

If you have bone metastasis, it means that cancer from another part of your body has spread to your bones. This is a sign of advanced cancer . In this case, you will need medical treatment and support for both the primary cancer and the bone metastasis.

It is very important not to panic, follow medical advice, and stay positive.

How long can you live with this condition?

It is difficult to give a single answer to this question. Because it depends on many factors. This period can vary, usually ranging from six months to more than four years. The main factors that affect it are:

• Type of cancer: According to one study, the survival time for lung cancer that has spread to the bones is about six to seven months, while for prostate cancer that has spread to the bones, the survival time can be about 53 months.
• Stage of cancer: People with cancer that is diagnosed at stage I (Stage I) are less likely to develop bone metastases than those diagnosed at stage IV (Stage IV). For example, researchers who tracked the rate of bone metastases 10 years after cancer was diagnosed found that 3% of people with stage I developed the condition, while 28% of people with stage IV developed it.

I had stage 1 cancer, which was in remission. Why did my cancer spread?

Unfortunately, sometimes even after cancer has been treated and is in remission , metastatic cancer, also known as bone metastasis, can develop. ``Remission'' means you have no symptoms and no signs of cancer can be found on tests. If you have bone metastases, your doctor may also call this condition distant recurrent cancer . Recurrent cancer is when cancer comes back after treatment.

How do I take care of myself?

Bone metastasis can affect your quality of life. Living with symptoms like pain and the feeling that the cancer is spreading is not easy. But here are some suggestions that may help you:

• Eat well: Complications from bone metastases can affect your appetite. Talk to a nutritionist to develop a healthy eating plan that works for you.
• Think about cancer survivorship programs: You've been a cancer survivor since the day you were diagnosed. Now that you're dealing with bone metastases, you're the same. There may be programs and support groups that help people in the same situation as you.
• Ask about palliative care: Often the first symptom of bone metastases is bone pain. This pain can be severe and affect your quality of life. Palliative care includes pain medication and other pain management support. Palliative care services also include psychological counseling to help you manage the emotional challenges that come with terminal cancer.
• Look into clinical trials: Researchers are looking into new ways to treat bone metastases from various types of cancer. Ask your doctor about clinical trials that might be right for you.

Should I consider hospice care?

It depends on your condition. If your doctor thinks that your cancer is unlikely to be cured with continued treatment, and that you have six months or less to live if treatment is stopped, he or she may recommend hospice care . Hospice care focuses on your physical comfort, freedom from pain, and managing other symptoms.

When should I see my doctor?

If your symptoms of bone metastases are getting worse, for example, if you have pain that you can't control even with prescribed medication, see your doctor right away. Remember, you don't have to live with the severe pain of bone metastases. Your doctor will prescribe pain-relieving medications and other treatments that won't affect your quality of life, including your ability to be with your loved ones.

When should I go to the Emergency Room?

If you have symptoms of spinal cord compression, you should call 911 or go to the emergency room immediately. These symptoms include:

• If your legs, soles of your feet, or lower abdomen feel numb or numb.
• If you have difficulty moving your legs.
• If you can't control your urination or defecation.
• If you can't urinate at all.

If left untreated, spinal cord compression can lead to paralysis, so be very aware of these symptoms.

What questions should I ask my doctor?

Finding out you have bone metastasis, when you're already dealing with cancer, can further affect your quality of life. Here are some questions you can ask your doctor:

• Which of my bones are now filled with cancer cells?
• How does having bone cancer affect my overall prognosis?
• What treatments or combinations of treatments can help me?
• Can treatments stop bone metastases from spreading to other bones?
• What are the options for managing my bone pain?
• How can I reduce the risk of breaking bones?

What is the difference between Bone Cancer and Bone Metastasis?

This is something that confuses many people.

• Bone cancer is a type of cancer that starts in your bones, such as osteosarcoma or Ewing sarcoma .
• Bone metastasis is when cancer that started somewhere else in your body later spreads to your bones.

Bone metastasis is a symptom of metastatic cancer. You may be told that you have bone metastasis, the first time you know that your cancer has spread from where it started. The news can be overwhelming and distressing. What's more, knowing that bone metastasis causes constant pain and affects your quality of life can be even more distressing. You may be worried and scared about what to expect next. But remember, your doctors are there to listen to you and understand your concerns. They can help you with everything from managing your pain to explaining what to expect if your cancer spreads.

Finally, take-home message:

Although bone metastasis is a serious condition, there are ways to manage it.

• The most important thing is not to panic and follow the doctor's instructions carefully.
• There are treatments to control pain and maintain a good quality of life.
• You are not alone. You have family, friends, doctors, and healthcare professionals to help you.
• Staying positive and mentally strong is very important on this journey.

If you have any more questions about this, don't be afraid to ask your doctor. He/she will explain everything to you.

` Cancer, bone metastasis, bone pain, cancer spread, cancer treatment, calcium increase, spinal compression