Bone Metastasis

At the U-M Rogel Cancer Center, treatment of bone metastasis takes place in the clinic where the originating cancer is treated. For example, if prostate cancer has metastasized into the bone, it is treated in the Urologic Oncology Clinic. Call the Cancer AnswerLine™ at 800-865-1125. for help finding the clinic you need. NOTE: Cancers of the spine are treated by our Spine Oncology Program.

Bone metastases are common among cancer patients. It is important to be informed of some of the common symptoms, how bone metastasis is diagnosed, and what treatment options are currently available. Be aware of your own body and share any concerns that you may have with your doctor.

What is Bone Metastasis?

The bone is a common site for metastasis. Bone metastasis or "bone mets" occurs when cancer cells from the primary tumor relocate to the bone. Prostate, breast, and lung cancers are most likely to spread to the bone. However, other cancers are not excluded. Bone metastases do not begin from the bones but move there from the primary tumor site. On the other hand, primary bone cancers are rare cancers where the primary tumor actually starts in the bone. Therefore, bone cancer and bone metastases are not the same.

As an example, consider a patient with prostate cancer. Prostate cancer cells from the primary tumor can break away and get into the bloodstream. Once in the blood, the cancer cell can travel to the bone and form a new (secondary) tumor. It is important to remember that this secondary tumor is made up of abnormal prostate cancer cells, not abnormal bone cells. The result of this process is referred to as prostate cancer that has metastasized to the bone or metastatic prostate cancer. This is otherwise known as bone metastasis.

When cancer cells metastasize to the bone, they can cause changes to the bone. The process by which portions of the bone are damaged is called osteolysis. Oftentimes, small holes result from osteolysis. These holes in the bone are referred to as osteolytic lesions or lytic lesions. Lytic lesions can weaken the bones and increase the risk of breakage or other problems. It is also common for bone metastasis patients to experience pain with lesions.

Bone metastases are common among cancer patients. It is important to be informed of some of the common symptoms, how bone metastasis is diagnosed, and what treatment options are currently available. Be aware of your own body and share any concerns that you may have with your doctor.

Bone Basics

Bones have many functions. They support us, allow us to move, and protect our internal organs. Bones store and release minerals that are important for our bodily functions. Our blood cells are also made and stored in the bone.

The outer layer of the bone is called the cortex. It provides most of the support for our skeletons. It is also the place where muscles and ligaments attach to allow us to move around. The material located inside our bones is called bone marrow. The marrow is living tissue that makes up the soft, spongy center of bones. The marrow is where red blood cells, white blood cells, and platelets are produced. These blood cells help keep us healthy. Red blood cells carry oxygen to the body's tissues from the lungs. White blood cells help us fight infection and disease. And, platelets help control bleeding by forming blood clots.

When cancer cells spread to the bone, it is harder for your body to stay healthy.

Cancer Facts

All of our organs are made up of cells. Normal cells divide and reproduce in an organized way. Cancer cells are abnormal. They keep dividing even when new cells are not needed. Sometimes cells form a mass of tissue called a tumor. Tumors can be either benign or malignant. Benign tumors are not cancer. However, malignant tumors invade healthy tissue and result in cancer. They can also spread to other parts of the body.

Primary cancers or tumors refer to cancer in its original location. Most primary cancers are named for the part of the body from where they started or for the type of cell. For example, breast cancer or small cell lung cancer. If cancer cells break away from the original (primary) tumor, they can travel to distant parts of the body through the blood or lymph. These malignant cells can form new tumors called secondary tumors or metastases in places such as the bone. The process of cancer cells moving to other parts of the body from the primary cancer site is called metastasis.

Our immune system destroys the majority of cancer cells circulating throughout the blood or lymph in our bodies. If cancer cells do not find a place to grow and reproduce, they will die or be destroyed. They need a favorable environment within the body in order to metastasize or spread. While cancer cells can metastasize in many areas of the body, some places are more common than others: bones, lungs, liver, lymph nodes, or the brain. The direction in which the blood moves through the body can also determine where secondary tumors will develop. For example, since the heart pumps blood through the lungs before sending it to the rest of the body, metastases to the lungs happen very often. In some cases, cancers will spread to the tissue or organ that is closest to the primary tumor.

Future Outlook

For the majority of bone metastasis patients, it is still possible to maintain a good quality of life. Depending upon where the bone metastasis is located, certain activities may be more difficult or even unsafe. You may need to make some changes in your daily routine to lower your risk of bone fracture or to decrease pain. However, most patients find that there are still many things that they can do on their own.

One way that progress in the treatment of bone metastases is being made is through clinical trials. Researchers run these trials to search for and test new treatments. Clinical trials can involve the use of new medications or new methods of treatment. Developments in existing treatments or a combination of treatments can also be studied. Clinical trials can help us to find new and better ways to manage bone metastases. Your doctor can update you with information on current clinical trials and discuss with you the ones that might be beneficial to you.

With the advances in medical science, many patients with bone metastases are living a better quality of life than before. New treatments are being discovered and present treatments perfected. In this way, we hope to secure a better future for those patients who have bone metastases.

At the U-M Rogel Cancer Center, treatment of bone metastasis takes place in the clinic where the originating cancer is treated. For example, if prostate cancer has metastasized into the bone, it is treated in the Urologic Oncology Clinic. Call the AnswerLine™ at 800-865-1125 for help finding the clinic you need. NOTE: Cancers of the spine are treated by our Spine Oncology Program.

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