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When Cancer Spreads to the Bone: Surgery for Metastatic Bone Disease

Last updated Thursday, August 13, 2009

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Basics of metastatic bone disease

Metastatic bone disease is a serious condition in which cancer has migrated from another part of the body, such as the lung, breast, prostate, thyroid, or kidney into one or more bones of the skeleton. Metastatic bone disease is not the same as cancer that originates in the bone, such as sarcoma. As a consequence, treating metastatic cancer that has gone to the bones is different than treating cancers that originate in the bones. Any kind of cancer can spread to the bone, but the most common are cancers of the kidney, thyroid, lung, breast, and prostate.

Immediate medical attention

Any new bone or joint pain should be taken very seriously in a patient who has a history of cancer, even if the cancer appeared to be in complete remission many years ago. Metastatic bone disease is heralded by onset of pain, usually in the arm, leg, back, or pelvis. Sometimes patients don’t know they have cancer until it spreads to the bone and causes enough pain that they seek medical attention. The physician then needs to find the original location of the cancer elsewhere in the body.

Facts and myths

Treating metastatic bone disease may not increase the length of time a patient lives, but frequently can increase the patient's quality of life. Radiation is used for pain control. Radiation doesn’t restore the integrity of the bone, and the patient may continue to be susceptible to fractures. Surgery can sometimes help protect the bone and make it easier for the patient to move around. The reduction of pain and the restoration of some activities, like walking, can improve a patient’s overall quality of life. Some people also believe that surgery should not be performed if the patient has only a short while to live. On the other hand, some patients think surgery is worth enduring if it gives them even a few more months of a more active, less painful, life. The ultimate decision on what treatments to undergo is individualized on a patient-to-patient basis.

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