Metastatic Bone Disease

What is metastatic bone disease?

Cancer that begins in an organ, such as the lungs, breast or prostate, and then spreads to bone is called metastatic bone disease.

With improved medical treatment of many cancers, patients are living longer. However, the primary cancers in more of these patients are spreading to bone. The tumors that result are called bone metastases.

The most common cancers that arise from organs and spread to bone include:

  • Breast

  • Lung

  • Thyroid

  • Kidney

  • Prostate

How common is metastatic bone disease?

More than 1.7 million new cancer cases are diagnosed each year, and approximately 50 percent of these tumors can spread or metastasize to the skeleton.

What causes metastatic bone disease?

Over time cancer cells that begin in an organ, the primary site, develop the ability to spread throughout the body. Though much is still unknown, current science suggests that cancer cells spread to areas of the body that have both a rich blood supply and an environment uniquely suited to foster cancer cell growth. Specific cancer types - breast, lung, prostate, and others - are more likely to spread to bone.

Dr. Collier's research lab, the Indiana Musculoskeletal Oncology Lab, is working to better understand why cancers spread to bone at different rates and numbers.

What are symptoms of a metastatic bone disease?

 

Many patients with metastatic bone disease will experience pain in the area of the tumor. This pain generally increases with activity.

Although bone tumors are not caused by trauma, an injury can sometimes cause a bone that is weakened by a tumor to fracture, or break. This is because metastatic bone disease removes portions of the bone and weakens its overall structure.

How do you diagnose metastatic bone disease?

 

​To be sure you have metastatic bone disease and to determine the extent, Dr. Collier will conduct a thorough evaluation and may order a number of tests, including:

  • Medical history and physical exam

  • X-rays

  • Other imaging studies (CT, MRI, Bone scan)

  • Biopsy

    • A biopsy may be necessary to confirm the diagnosis of metastatic bone disease and guide treatment. There are two basic methods of performing a biopsy:

      • Needle biopsy - After given local anest​hetic or sedation, a needle is inserted into the tumor to remove some tissue. The tissue is then evaluated under a microscope to confirm the diagnosis. A needle biopsy is most often done by a radiologist.

      • Open biopsy - An open biopsy is performed in an operating room by a surgeon.

  • Blood and/or urine tests

How do you treat a metastatic bone disease?

Many bone metastases can be treated without surgery using observation or radiation therapy alone. Surgery may be recommended if the bone is at high risk of fracture or if the number of metastatic sites is limited.

 

If necessary, the type of surgery performed depends on the type and location of the metastatic bone disease. It may involve strengthening the bone with orthopaedic hardware, resecting the tumor, and/or joint replacement surgery.

  

Dr. Collier will work with you and your family to develop a personalized treatment plan for your specific tumor and location.