ZOMETA-Lehrmaterialien

Bone Health, Bone Metastases & How Cancer Spreads to Bone: Questions and Answers

I don't have bone cancer. Why should I worry about my bone health?

Cancer can have many consequences. Even if you do not have bone cancer, your bones can be affected. The cancer medication you receive may cause bone loss, resulting in weaker bones (1). Cancer can spread to bone, in a process called metastasis (3). The new clusters of tumor in the bones are called bone metastases (3). Bone metastases are extensions of the original cancer which has spread to bone (3). They can occur even if the original cancer is treated (3).

Which types of cancer spread to bone?

Some cancer tumors are more likely to spread to bone than others. When cancer spreads to bone, it is said to metastasize. The cancer tumors most likely to spread and develop bone metastases are breast cancer, prostate cancer, lung cancer, and multiple myeloma (a cancer that begins in the bone marrow) (3). Other cancers that sometimes spread to bone are kidney cancer, cancer of the bladder, gastrointestinal cancers, head and neck cancers, and blood-related tumors (lymphoma and leukemia) (1,3).

How do bone metastases affect the bone?

To understand how bone metastases affect bone, let's look at the life cycle of normal bone. Normal bone is an active tissue throughout life (1). Small areas of bone are constantly being worn away by special cells called osteoclasts (1). The chemicals that made up the worn away bone are reabsorbed into the blood (1). New bone is then built up by other cells, called osteoblasts (1). Osteoblasts take chemicals from the blood to create this new bone (1). This process of breakdown and buildup is coordinated by hormones and other chemicals that the cells secrete into the blood to communicate with one another (1).

In areas of bone metastases where cancer has spread to bone, the bone damage is greater than would be expected from just the tumor pressing on the bone (1). In fact, tumor cells secrete chemicals that stimulate osteoclasts (1). The osteoclasts wear away portions of bones (reabsorption) leaving holes in the bone, called osteolytic lesions (3). The tumor cells can also secrete chemicals that cause the build up of abnormal bone (3). This is called osteosclerotic bone (3). Both types of abnormal bone can be painful and are weaker than normal bone (3). Both make bone more likely to break or collapse (3).

What are the symptoms of bone metastases?

Symptoms of bone metastases include bone pain and difficulty walking and performing your daily activities (2). If you experience these symptoms you should tell your doctor.

How could bone metastases affect me?

Problems caused by bone metastases include pathologic fractures (broken bones), spinal cord compression (pressing on the spinal cord), nerve compression at the root (where the nerve exits from the spinal cord, hypercalcemia (high blood calcium), and decreased activity of the bone marrow (where new blood cells are made) (1).

Where do bone metastases usually occur?

Some common areas of bone metastases are the ribs, spine, pelvis, skull, and the arm and leg bones closest to the body (the humerus in the arm and the femur in the leg) (4).

Is there any treatment for the abnormal bone from bone metastases?

The abnormal bone created by bone metastases can be treated by medications called bisphosphonates (1,3) For this reason, it is important to inform your doctor as soon as possible if you experience bone pain, weakness, or decrease in sensation.

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