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Frequently Asked Questions

What is bone metastasis?
Bone metastasis or "bone mets" occurs when cancerous cells from the primary tumor relocate to the bone. Specifically, prostate, breast and lung cancers are most likely to spread to the bone, although nearly any cancer can do so. Bone metastases do not begin from the bones but rather from the primary tumor site. On the other hand, primary bone cancers are rare, where the primary tumor actually starts in the bone. Therefore, bone cancer and bone metastases are not the same. For example, consider a patient with lung cancer. Lung cancer cells from the primary tumor can break away and enter the bloodstream. In this way, it can travel to the bone and form a new (secondary) tumor. The secondary tumor is made up of abnormal lung cancer cells, not abnormal bone cells. The result of this process is referred to as lung cancer that has metastasized to the bone or metastatic lung cancer. Simply, we refer to this process as bone metastasis.

How common is bone metastasis?
Many cancer patients have bone metastasis. An estimated 170,000 new cases of bone metastases are diagnosed annually in the United States. Indeed, there are estimated over 500,000 Americans alive with bone metastases. As a result, the Multidisciplinary Bone Metastasis Clinic has evolved at the University of Michigan to improve the quality of care rendered to patients with bone metastasis. As well as to provide bone metastasis patients and community oncologists a clinic visit where all the opinions necessary and appropriate for this patient population will be given. The clinic will also conduct clinical investigations for this widespread oncologic occurrence.

What are the signs and symptoms of bone metastasis?
The symptoms for bone metastases vary among patients. However, some patients do not have any symptoms at all. There are times when the primary cancer is not detected until a patient comes to the doctor with symptoms caused by the metastasis. The most common symptoms for bone metastasis include bone pain, bone fracture and spinal cord compression.

Bone Pain: It is usually the first symptom that patients notice. The pain is often at the site of the metastasis, which is referred to as localized pain. Patients can experience pain in the areas surrounding the bone metastasis. Depending on the location of the bone metastasis, pain can vary. Bone metastasis to the spinal cord can often cause discomfort or pain that worsens at night or with bed rest. Bone metastasis to the long bones of the arms and legs can cause pain with activity and occasionally that pain can be relieved with rest. Bone metastasis patients often describe the pain as gradually increasing over a period of time and becoming more severe.

It is important to know that not all bone pain is bone metastasis. Your health care provider can help determine if your symptoms are from bone metastasis, other sources or normal aches and pains.

Bone Fracture: Too much force or stress on a bone will lead to fracture. Fracture describes a bone that is broken or cracked. Bone metastasis can weaken bones and increase the risk of fracture. Impending fracture describes a bone at risk for fracture. If detected early, your health care provider may be able to provide treatment to prevent fracture. Bone metastasis patients frequently have bones that are more fragile and care is needed when performing daily activities. Consult with your health care provider to determine which activities are safe to continue and which activities to discontinue.

Spinal Cord Compression: If the secondary tumor is located in the spinal area, it can result in spinal cord compression. Spinal cord compression occurs when the tumor squeezes the spinal cord. This can lead to back pain or make walking painful and difficult. Other symptoms might include numbness and weakness in the legs, problems with bowels or bladder, or numbness in the abdominal area.

What about treatment?
Bone metastases can be managed. The goal of treatment is to decrease pain, prevent further bone breakdown and to restore function to patients with bone metastasis. This is done, in part, by strengthening the bone and reducing the risk of fractures. Ultimately, treatment is intended to improve the patient's quality of life. Options for treatment include pain management, radiation, chemotherapy, hormonal therapy, surgical fixation, radiopharmaceuticals or combination therapy.

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See Also
Bone / Bone metastasis Clinical Trials
-on UMClinicalStudies.org