When Cancer Spreads to the Bone: Surgery for Metastatic Bone Disease
Last updated Thursday, December 13, 2007
Prognosis and impactsHow serious is metastatic bone disease? Is metastatic bone disease chronic? The appearance of metastatic bone disease is very serious and can
worsen a patient’s overall prognosis. Left untreated, it has a severe
effect on the remaining quality of life. A patient can become
profoundly hypercalcemic (have very high levels of calcium in the
blood), which can be dangerous. When too much calcium is released into
the bloodstream, the patient can become prone to gastrointestinal
symptoms, psychiatric symptoms such as delusions, and kidney stones. If
the cancer spreads from the bones to the lungs, the consequences can be
fatal. In a few patients whose initial treatment was successful,
metastatic bone disease can be a chronic problem. The patient may, for
example, have an isolated problem in a leg bone, get it treated, and
live several years before the disease reappears in the spine or arm.Is metastatic bone disease deadly? How lethal metastatic bone disease is depends on the patient’s original
type of cancer and how much the cancer has spread. Widespread
metastatic bone disease has a poor prognosis. However, the outlook may
be better for those patients who have just one or two spots in their
bones. Patients may find some peace of mind from knowing that not all
patients with metastatic bone disease have a grim future. Medication
and surgery can help keep the symptoms of the disease at bay and help
permit a good level of activity.Will metastatic bone disease cause pain? Pain is usually what prompts the patient to seek medical attention.
Rarely is metastatic bone disease an incidental finding during a
routine exam. Patients usually describe the pain as body aches that
occur during the night, and feel like a bad toothache.Will metastatic bone disease be debilitating? How debilitating metastatic bone disease is varies from person to
person, depending on which part of the skeleton is affected. For
example, a metastasis that appears in the right arm of a left-handed
person causes less trouble than if the patient were right handed.Will metastatic bone disease cause discomfort? Metastatic bone disease will cause some degree of discomfort. The
amount will vary from person to person. Radiation treatment,
medications, surgery, and other pain management techniques can often
make the patient more comfortable. Patients should let their doctors
and nurses know if they are in pain, where it hurts, how severe it is,
and how the pain is affecting their daily lives. Their doctors and
nurses can then find ways to try to reduce the pain. More can be done
today to lower the musculoskeletal pain from cancer than was available
in the past.Is metastatic bone disease curable? While treatment may improve the patient’s comfort and function, reduce
pain, and prevent additional suffering from fractures, treatment is
rarely curative.Will metastatic bone disease change the patient?s ability to have children or get pregnant? Metastatic bone disease has no effect on fertility. However, because
metastatic bone disease usually doesn’t occur until after age 40, most
women who develop metastatic bone disease are no longer in their prime
childbearing years.Will metastatic bone disease change the patient's independence? Metastatic bone
disease may lessen independence in a significant number of, but not all,
patients. Some patients with metastatic bone disease have chronic pain that
requires treatment with sedating medications. Those whose bones are affected in
the lower part of the body may have difficulty walking. If the bones in the
arms are affected, patients may have problems carrying out the daily activities
of living, such as cooking, writing, cleaning, shopping, and personal
care. Patients will likely have to stop
working. Some will need to use a wheelchair to get around. Because of their
restricted range of movement, and if they are taking narcotics to curb their
pain, some patients will not be able to drive.
The loss of independence may be especially
difficult for cancer patients who felt they have gotten their daily life back
and have been disease-free from cancer for 10 or 20 years, only to have their
activities curtailed by pain and bone deterioration. However, surgery or
radiation might be able to reduce the pain to the point where narcotics are not
needed, and might be able to reduce other disabilities from the disease.Will metastatic bone disease change the patient's ability to move about? The limitations that
metastatic bone disease places on mobility depends on which bones have the
disease, how many bones are involved, and how much area of each bone is
damaged, and the severity of the damage. Patients should check with their
doctor to see if treatment can help restore some of their lost mobility or
reduce their risk of fractures.Will metastatic bone disease alter activities of daily living (e.g. work, sports, housework, etc.)? Whether metastatic
bone disease alters activities of daily living depends on where in the skeleton
the disease is occurring. For example, metastasis in the arm bones or in the
upper backbone may limit the ability to do housework, work at a computer, use
hand tools, or do lifting. In addition, a patient’s energy for accomplishing
tasks may be low, especially while he or she is receiving radiation.Will metastatic bone disease cause fatigue or changes in metabolism? As with many other
forms of cancer, metastatic bone disease is often accompanied by fatigue. In
addition, the narcotics to treat pain are often sedating. Radiation and
chemotherapy can also cause fatigue, and patients often suffer from sleep
problems, including being woken up by pain. This loss of nighttime sleep can
lead to daytime drowsiness. Depression may also make it hard to get up the
energy to do things. Some forms of cancer can cause anemia and its resulting
tiredness. Some causes of fatigue, such as depression, anxiety, insomnia, and
anemia, can be addressed to reduce its impact.Will metastatic bone disease require a change in diet? There are no specific
diets, dietary restrictions, or requirements for people who have metastatic
bone disease.Will metastatic bone disease have implications for relationships, social support, and interactions with family? A person who has
metastatic bone disease may need more practical help, because the disease might
have significant impact on his or her independence and mobility. A patient will
likely have repeated visits to the doctor, which will take up a sizeable amount
of time, especially if the patient lives in a rural town and must travel a long
distance for treatment. Sometimes receiving cancer treatment, or caring for a
relative with metastatic bone disease, can seem burdensome at times. For
example, radiation therapy often requires several weeks of daily treatments at
the hospital or clinic. If the patient already has stresses in his or her life,
or has had difficult interpersonal relationships before the disease occurred,
these may become worse because of the demands of living with cancer. On the
other hand, sometimes the appearance of a serious disease can change people’s
outlooks in such a way that family, friendships, and other personal
relationships become more important and stronger.What other impacts might metastatic bone disease have on the patient's life? Is it contagious, disfiguring, etc.? Metastatic bone
disease is not contagious, nor is it disfiguring.
One of the impacts of the disease is that some
patients will have metal surgical hardware placed in their body to treat a
fracture or a bone about to fracture.Surgery for Metastatic Bone Disease at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
How useful was this page or article?
|
|