Treatment of bone metastases: drugs. Metastases in the bones: prognosis and photos Total damage to the skeletal bones

Bone metastases are the most severe pathology that accompanies cancer diagnoses. This mainly happens in the last, most severe – stage 4 cancer. Neoplasms are characterized by the penetration of cancerous cells into the bone tissue, entering there through lymph flows or blood.

Considered a secondary focus of a malignant tumor disease, metastases appear in every three out of four cases of cancer diagnosis. Very often, the pathology is a rather dense, large-sized formation. Up to 80% of this complication occurs against the background of breast cancer in women and prostate cancer in men.

Depending on the anatomical nature and specificity of tumor cells, in oncological practice there are two main types of them, which appear extremely rarely in the pure type, mainly showing their hybrid forms:

• osteoplastic– characterized by dense bone malignant neoplasms;
• osteolytic– there are no large tumors, rapid destruction of the bone tissue structure occurs.

Most often, metastases affect bones equipped with a large number of blood vessels – costal, humeral, large and small pelvis, external cranial. At the initial stage, they behave secretly, but as the affected cells multiply, a severe pain relapse occurs.

Signs

As noted, initially the metastasis behaves incubatively, remains hidden and does not cause discomfort - as a rule, a person does not even suspect its existence. However, over time, fairly clear clinical signs and symptoms are evident.

Most often, the following evidence indicates that the body is affected by metastases: their manifestations:

• fractures;
• intoxication;
• compression;
• pain syndrome;
• hypercalcemia.

It is preferable to stop at each clinical manifestation in more detail, since each of them, in case of failure to provide untimely medical care, or with incorrectly prescribed therapy, can lead to dire consequences for the patient.

Fractures. They are pathological in nature. It manifests itself in a sharp decrease in the hardness of the bone material - often even minimal mechanical or physical stress is enough - and the tissue breaks.

In advanced forms of pathology, when a large focus of tissue is affected by metastases, it happens taking too deep a breath or sneezing is enough so that, for example, a rib is broken. And when sudden turn of the body or tilting too low, the skeletal pelvic part becomes vulnerable.

The main reason leading to this symptomatology is the leaching of the most important bone material responsible for their strength - biophosphate - as the tumor multiplies.

Intoxication. A very common syndrome. It manifests itself in the form of general weakness, loss of interest in food, and, as a result: critical loss of body weight, nausea, depression and apathy towards what is happening - up to a complete loss of interest in life. This is a nonspecific manifestation any type of cancer, which rapidly increases during the process of metastasis.

Compression. Tumors that arise in hard tissue are very dense and hard in composition and can exert significant pressure on the bloodstream. vascular system and nerve fibers.

Compression can lead to the most critical consequences nerve endings spinal cord . This threatens a cancer patient general defeat nervous system, and, as a result, complete or partial paralysis of the body.

At the initial stage, the symptom manifests itself in limb dysfunction. As the disease progresses, the degree of immobility increases.

Pain. This syndrome is the most common and hardest to tolerate by the patient. Painful sensations can cause severe torment and are difficult to correct with painkillers.

The syndrome is growing, reaching its peak at night and after even minimal physical activity in the affected area. In especially clinical forms of its manifestation, it is capable of driving a sick person to suicide.

Hypercalcemia. In medical terminology, it means an increase in the percentage calcium components in the patient's blood due to abnormal resorption of hard bone tissue.

Accompanied by severe thirst, dry mucous membranes oral cavity, a tendency to frequent and profuse urination, sudden manifestations of nausea and severe vomiting, slow reactions, and periodic disturbances in conscious perception of reality.

The most complex complication that poses a serious threat to human life, since in the shortest possible time it can lead to complete dysfunction of the main organs and systems vital functions of the body - heart failure, general dehydration, kidney disease.

Along with the listed symptoms, the following manifestations of the disease may occur:

• skin changes;
• ulcerative formations;
• osteochondrosis;
• manifestations of arthritis;
• rheumatism, not previously diagnosed.

People with metastases in the bones should pay extreme attention to all manifestations of the disease without exception - this may be the first warning sign that the doctor must know about. After the examination, he will determine how severe the pathology is and how to deal with it.

Causes and development of the disease

Almost every case of oncology is associated with metastasis, but not all bones of the human skeleton are equally susceptible to this pathology. What is the risk group?

Let's dwell on main types of bones and their inclinations and this process:

• hands and feet, feet, ribs, skull– are carriers of pathology only in situations where the disease is focally malignant;
• spine– for breast tumors;
• pelvic part– when the oncological process is close to it;
• femoral– due to its impressive size, it very often becomes a source of disease.

As a rule, the following diagnoses become the cause of bone metastasis:

• cutaneous superficial melanomas;
• lung cancer and oncology respiratory tract – the most common cause of hard tissue lesions – they grow into the spine;
• prostate tumor– slowly kills the femur, lumbar region and thoracic region spine;
• lymph node cancer- threatened lower limbs, radial and ulnar hard tissues;
• kidney oncology– affects the spinal cord;
• education in the field thyroid gland – affects the bones of the limbs.

For a more complete understanding of the clinical situation, a table is provided showing the frequency of bone metastases for the most common malignant tumor diagnoses:

Diagnostics

It is very important to correctly diagnose the type of metastasis in the bones - this allows you to at least somehow control the processes of damage and tissue destruction.

The following diagnostic methods are used:

• neurological examination– the specifics of the disease, its clinical features and manifestations are determined. During the examination, it is taken into account that signs of metastasis can appear both at the same time as the development of oncology, and much later; in addition, the absence of a neoplasm is not a reason to exclude them;
• scintigraphy- one of the ways to determine the presence of a disease using radiation. Radio drugs enter the body and, based on the isotope radiation pattern, I diagnose the disease;
• radiography– a method proven by practice and time, but in the early stages it may not reveal pathology;
• CT, MRI bone– indicated for diagnosing the spinal cord and brain;
• Blood chemistry– a very accurate method that shows an objective clinical picture of the development of the disease. Determines the degree of damage and the internal structure of cancer cells.

Treatment

The following methods of treating bone metastases are practiced:

• elective surgery– justified when the defeat process is not too advanced. Used in combination with other types of treatment;
• emergency intervention for spinal cord compression- Very dangerous form, any therapy other than surgery is powerless in this situation. The main task of the surgeon is to respond as quickly as possible to the growth of pathological disorders. There is little time allotted, and any delay could cost the patient his life;
• radiation therapy– used in a course for 2-3 weeks. The principle of operation is based on the susceptibility of cancer cells to the effects of radio rays. As for this problem, the method is not always effective;
• chemotherapy– slows down further growth and the spread of pathology. Works well at stages 1–2 of the disease;
• anesthesia– a method accompanying the main treatment. Mainly non-steroids and potent narcotic substances are used, which, when used systematically, cause dependence and a decrease in the effectiveness of the action.

Forecast

Metastases found in bones due to cancer kidney, if treatment is not carried out, they give the person the opportunity to live about a year, due to cancer thyroid glands – near 3-4 years, at melanoma – a few months.

If you contact a specialist in time to start therapy, the chance to live a full life is undoubtedly greater. With correct treatment and patient compliance with all recommendations, you can not only cope with the disease, but also return to a full life.

5354 3

Metastases in the bones are the most severe complication of cancer. Typically, the development of pathology indicates the last fourth stage of cancer.

In cases where the disease is advanced and the metastases have already settled deep in the bones, life expectancy is insignificant and is only a few months.

Metastases are characterized by damage to bone tissue by cancer cells. Abnormal cells enter the bones through the blood supply or lymph flow.

Since the role of bone tissue in the body is great (musculoskeletal function, accumulation of minerals, etc.), its damage negatively affects the quality of life of a cancer patient.

Most often, the appearance of metastases in the bones occurs during the primary development of the following types of cancer:

• mammary gland;
• prostate gland;
• lungs;
• thyroid gland;
• kidney

Although bone metastases can also appear when cancer affects other organs. Most often, pathology develops in the ribs, spine, skull, as well as the femur, humerus and pelvic bones.

Development and growth of bone metastases

The occurrence of bone metastases is associated with a feature of the human body - constant bone formation. This is happening process thanks to two types of cells:

• osteoclasts (responsible for the destruction and absorption of bone cells);
• osteoblasts (responsible for the production of new bone tissue).

When a person is healthy, a complete renewal of bone tissue occurs approximately once every 10 years.

When bones are damaged by cancer cells, the mechanism of action of osteoclasts and osteoblasts is disrupted.

Depending on the type of damage to bone cells, metastases are distinguished into two types:

1. At osteolytic type Cancer cells attack osteoclasts, causing thinning of bone tissue, which is accompanied by frequent fractures at the slightest load.
2. Osteoblastic type characterized by damage to osteoblasts. In this regard, there is an unnatural increase in bone tissue, the appearance of growths and other neoplasms. Most often, patients suffer from mixed type when thinning of the bone and the appearance of bone tumors occur simultaneously.

Symptoms and characteristic signs

Sometimes the earlier appearance of bone metastases is asymptomatic, but in most cases the pathology is accompanied by attacks of severe pain, which constantly increases.

The appearance is explained pain the fact that the amount of mutated tissue is constantly growing, and therefore compression of the nerve endings occurs.

Intraosseous pressure also increases. Almost always, the pathology is accompanied by a violation of the motor function of the body.

The main symptoms of metastases that have penetrated into the bones include:

Diagnostic techniques

Used for diagnostics different methods research:

The choice of diagnostic method may depend on the characteristics of the disease (patient complaints) and the medical equipment of the clinic.

Goals and methods of therapy

Despite the fact that the prognosis for bone metastases in most cases is unfavorable, you cannot hang your head and refuse treatment.

Treatment measures in the early stages make the patient’s life much easier and also increase his chance of life. If metastases that have penetrated the bones are diagnosed, treatment must be started immediately.

About goals

The main objectives in the treatment of metastases:

• reduction of pain;
• destroying cancer cells and preventing their proliferation;
• getting rid of intoxication;
• treatment of concomitant diseases (for example, fractures).

It is imperative to treat the primary one, regardless of its location.

Therapy methods

In order to cure bone metastases, the following techniques are used:

Often the doctor recommends highest efficiency combine medication with chemotherapy or radiation therapy. In addition, the patient is prescribed medications that are aimed at reducing pain, and immunostimulants to increase the body's defenses.

But you should not resort to treatment with folk remedies, since such actions can be aggravated by even greater complications. It is necessary to act according to the recommendations and advice of the oncologist.

Prognosis and life expectancy

In most cases, when metastases are diagnosed, the prognosis is unfavorable. The presence of pathology indicates stage 4 cancer.

The life expectancy of such patients ranges from three months to a year; in rare cases, the patient manages to live for two years.

The life expectancy with metastases in bone tissue is affected by:

• treatment of primary oncology;
• stage of development;
• features of the course.

The earlier the pathology is detected, the greater the chances of life, so early diagnosis and correctly prescribed treatment play a key role in this matter.

For prevention purposes

The main point in preventing the appearance of metastases in the bones is diagnosing the primary tumor in the early stages. This allows you to start treatment in a timely manner and stop the process of proliferation of cancer cells and their damage to other organs.

Also plays an important role correct treatment, aimed at destroying pathological cells and increasing the body's resistance to disease.

To reduce the risk of developing pathology, you need to follow all the doctor’s recommendations regarding diet, physical activity, intake medicines and so on.

Metastases in bones - severe complication oncology, which is accompanied unpleasant symptoms. With the development of pathology, the prognosis for life is poor.

But if the complication is diagnosed in a timely manner and treatment is started, the patient’s life expectancy will be increased and the quality of life will be improved.

Cancer is one of the most terrible and the most dangerous diseases threatening humanity. Oncological pathologies are numerous; they develop suddenly, sometimes without any previous signs. It is also important to remember that cancer at certain stages can spread throughout the body, which is how metastases appear in the bones.

In such situations, we must not forget that the skeletal system plays a vital role in human body. Bones are responsible not only for musculoskeletal functions, they are the focus of the accumulation of minerals, etc. Metastasis to bone structures is one of the most severe forms of cancer; in order to resist pathology, you need to know as much as possible about it.

To answer this question, you need to understand the nuances of what the process of metastasis itself is.

So, the term metastasis in medicine refers to a secondary tumor that originates from the primary focus of a malignant tumor. Metastases can spread throughout the body, affecting nearby or distant organs, as well as entire systems, including bone structures.

It is important to understand that bone metastases are precisely a secondary type of tumor, since a primary tumor is one that initially appeared and grew in the bone. Metastases enter bone structures and affect them due to the spread of malignant blood cells throughout the body, which circulate through the lymphatic or bloodstream (lymph and blood flow).

The process of metastasis occurs mainly at the last and most severe, that is, the fourth stage of cancer. Moreover, according to statistics, about 80% of all cases of bone metastasis occur due to breast cancer, prostate cancer, lung cancer, etc.

In other words, it is the listed types of oncological pathology that in most cases give metastases, which subsequently affect the skeletal system and lead to bone cancer.

Causes and types

As mentioned above, the main cause of metastasis and secondary bone cancer lies in the oncology of any organs. In most cases, the development of pathology occurs with cancer of the following localization:

• for breast cancer;
• thyroid gland;
• lungs;
• kidney;
• with an increased likelihood of bone metastases in prostate cancer;
• organs gastrointestinal tract, mainly the stomach;
• ovaries, etc.

These types of cancer are more likely than others to metastasize to the bones, but this does not mean that other types of cancer cannot cause bone cancer.

In addition, some scientists argue that metastases do not affect all bones. The formation of neoplasms occurs predominantly in large bone structures and hollow bones. In general, it can be said comparative characteristics, comparing tumor formation and the likelihood of metastasis. This characteristic is as follows:

• With breast cancer, that is, mammary glands, metastasis more often occurs to the bone structures of the spinal column.
• Metastases in the ribs, hands, feet, as well as in the bones of the skull appear mainly in global oncological lesions in the late stages of the oncological process.
• Another “favorite” site for metastases is the bones of the ace and thighs. This is explained by the fact that the bone structures in these areas of the skeleton are very massive.

If we talk about the causes and types of bone metastasis, we cannot fail to mention the division of bone metastases into two main types:

1. Osteoblastic metastases - their characteristic feature is the formation of compactions directly on the surface of bone structures.
2. Osteolytic metastases - this case is fundamentally different from the previous one, since the bone tissue and the bone itself are destroyed, pathological process comes from within.

Taking into account the two types of metastases described, one more cause of bone cancer can be identified. To do this you need to know what is in the body healthy person Bone tissue is continuously renewed, processes of resorption, bone formation, and remodeling occur. The functioning of renewal processes depends on the activity of certain cellular units - osteoclasts and osteoblasts.

In patients with metastases, pathological cells penetrate into the cellular structure of the bones, and the work of osteoblasts and osteoclasts is disrupted. As a result, the normal regulation of the processes of formation, absorption and destruction of bone tissue is disrupted, healthy cells are replaced by pathogenic ones. A particularly severe pathological process is diagnosed when metastases enter the bone marrow.

A separate reason for the development of oncology, which is important to mention, is bone fractures. Most doctors agree on the theory that fracture sites, even after decades, are more likely to become sites of cancerous tumors. According to this theory, the chance of bone metastases is higher in the place where the fracture was once localized.

In addition, in addition to the increased likelihood of large bone metastases, bone structures with an abundant blood supply also fall into this category.

Symptoms and characteristic signs

The process of formation of bone metastases has different symptoms; in some cases, the clinical picture depends on where exactly the tumor is localized and growing. The point is that in some cases, atypical clinical signs characteristic of the manifestation of cancer in certain areas of the skeleton appear in the general symptoms.

But before moving on to such features and special cases, it is worth considering the general clinical picture in patients with metastases. To begin with, it is worth saying that the first stages of the development of metastases in the bones are completely asymptomatic. The only symptom, which also does not appear in everyone, is increased fatigue and general malaise. As the pathology develops and the tumor grows, the following symptoms appear:

• Pain with bone metastases is the main and most striking symptom, which is present in 98% of cases. The pain syndrome is localized mainly in the place where the malignant neoplasm was localized. The nature and specificity of the pain is constant and tends to intensify with physical activity, in motion, as well as during night sleep with muscle relaxation.
• With the development of the tumor process, swelling appears. The swelling also has a clear localization; it surrounds the tumor. This means that if we are talking about a hip tumor in hip joint, there will be swelling around this area. The exception is lesions of deep bone structures, in which case the swelling may be hidden.
• Distortion or deformation of the affected area. In this case, the tumor grows and protrudes, forming a kind of lump or lump. The size of the deformed area depends on the size of the neoplasm itself.

In general clinical picture there are also signs of causeless weight loss, constant low-grade fever, lethargy, drowsiness, loss of strength, loss of appetite and increased sweating. All these clinical signs are invariably present at the stages of metastasis, because in this case we have to talk about severe progression of oncology.
In addition, metastasis of bone structures is accompanied by atypical symptoms, the following disorders occur:

• Pathological fractures – clinical sign comes into force at that stage of the oncological process when more than 50% of the patient’s cortical layer of bone structures is destroyed. In such cases, bones become brittle and joints become fragile. The spine, pelvic bones, and central sections of the tubular bones suffer the most. A fracture can occur from a minor blow or even from an unsuccessful movement;
• Spinal cord compression – manifestations of compression mainly affect the thoracic spine. Less often it is the lumbosacral region and in only 10% of cases it is the cervical region. In addition to painful sensations, compression is accompanied by a gradual loss of musculoskeletal functions, paralysis of the limbs and areas of the body that are controlled by the nerves in the corresponding part of the spine. There is a violation of blood circulation, as well as the functioning of the nervous system;
• Hypercalcemia - develops due to excessive activity of osteoclasts, due to which calcium is “washed out” into the blood from damaged bones, which negatively affects kidney function. As a result, the patient develops polyuria, as one of the complications, and serious disorders of various body functions begin. As a result, disturbances in the functioning of the nervous and of cardio-vascular system, kidneys, organs of the gastrointestinal tract.

How to determine?

If appropriate symptoms appear and there is suspicion of the formation of metastases in the bones, it is necessary to consult an oncologist. To confirm the diagnosis, the specialist must prescribe a number of diagnostic measures to the patient.

As part of the diagnostic examination, the following are required:

How to treat?

Bone metastases are a disappointing diagnosis, but they are not a reason to refuse treatment. Even if therapy does not guarantee recovery, adequate treatment of bone metastases significantly alleviates symptoms, improves the patient’s quality of life, and also increases life expectancy.

In general, for bone metastases, the treatment regimen involves an integrated approach, which includes:

Treatment requires the mandatory involvement of an oncologist. resort to folk remedies fighting cancer is highly not recommended, since such exposure can only aggravate the patient’s condition and provoke the progression of the disease.

How long do they live?

Bone metastases are a disappointing diagnosis, because in this case we are talking about a severe stage of cancer progression. At the same time, it is very difficult to predict life expectancy, because it is necessary to take into account a lot of different factors.

One of the complications cancer diseases is , which can spread into soft fabrics and distant organs.

Metastasis also occurs in the bones. In fact, bone metastases are secondary cancerous tumors of bone tissue, formed as a result of the transfer of atypical cells from the main focus through the blood and lymph flow.

Typically, bone metastases occur in the last stages of cancer pathology. Moreover, about 80% of cases of bone metastasis occur against the background of and. Such formations appear severe pain, frequent fractures and hypercalcemia.

Causes

Most often, metastasis to bone structures occurs with prostatic and mammary glandular cancer, malignant formations in and gastrointestinal structures, and.

They metastasize to bone tissue and other malignant neoplasms, but much less frequently.

When a person is healthy, his bone tissue is constantly renewed. In general, bone structures are characterized by processes of resorption, remodeling and bone formation. These processes are carried out due to the cellular activity of osteoblasts and osteoclasts. These cellular structures are responsible for the formation, absorption and destruction of bone tissue.

If atypical cells penetrate into the bone structures, then a disruption in the functioning of the bones occurs. Healthy cells are displaced, the processes of interaction between osteoblasts and osteoclasts are disrupted, which leads to the dissociation of their activities.

For breast cancer

Metastasis to bone structures in breast cancer occurs in a lymphogenous and hematogenous manner. Such localization of metastases in breast cancer is quite common.

Cancer with such metastases is characterized by severe pain and an excessive tendency to pathological fractures, especially in chest and pelvic bones.

Types

Depending on the type of cell activation, oncologists distinguish several types of bone metastases:

1. Osteoplastic– accompanied by the formation of compactions on the bones;
2. Osteolytic– when there is a predominant destruction of bone structures.

Pure types are relatively rare in medical practice; mixed forms are much more common.

The bones that have a rich blood supply are most susceptible to metastasis, i.e. in the humerus and femur, ribs and vertebrae, cranial and pelvic bones. At first, bone metastases do not manifest themselves, but over time they become the cause of intense pain, which is associated with stimulation of periosteal pain receptors.

Symptoms of bone metastases

At first, secondary bone tumors develop asymptomatically, but with the development of the tumor process, a certain clinical picture is formed:

• Presence of hypercalcemia;
• Tendency to pathological fractures;
• Presence of spinal compression.

Hypercalcemia is a life-threatening complication that is found in approximately 30-40% of cancer patients with bone metastasis.

This condition occurs due to excessive activity of osteoclasts, leading to an increase in the level of calcium in the blood, which in turn causes a pathological increase in the excretory capacity of the kidneys.

As a result, in cancer patients with metastatic foci in the bones, in addition to hypercalcemia, hypercalciuria develops, and the reabsorption of fluid and sodium is impaired, leading to polyuria.

As a result of such changes, the activity of many systems and organs in cancer patients is disrupted:

1. In nervous system activity, signs such as lethargy and mental disorders, confusion and affective disorders are noted;
2. In cardiovascular activity, deviations such as arrhythmia and low blood pressure, decreased heart rate occur, and the risk of cardiac arrest is high.
3. The kidneys are affected by nephrocalcinosis and polyuria;
4. In the gastrointestinal area, nausea and vomiting syndrome, frequent constipation and lack of appetite are observed, and pancreatitis may develop.

If more than half of the cortical layer is destroyed during bone metastasis, pathological fractures appear. They are usually found in the bone tissues of the spine (lumbar or thoracic) and femur. A fracture can occur even in minor traumatic situations such as an awkward turn or a weak blow.

Often such fractures appear without visible external cause. With a pathological fracture, displacement of bone fragments may occur, which leads to functional disorders limbs (if the fracture is localized on a long tubular bone) and neurological disorders (if the fracture is localized on vertebral structures), which significantly worsens the quality of life of the cancer patient.

A growing tumor and bone fragments can put pressure on neighboring tissues.

With tumor compression, the cancer patient experiences increasing pain, weakness of muscle tissue worries, signs of impaired sensitivity appear, and in the terminal stages dysfunction of the pelvic organs and paralysis occur.

If metastasis is observed in the vertebral tissues, then spinal compression sometimes occurs in cancer patients. Typically, this phenomenon occurs with metastasis to the thoracic vertebrae. Disorders caused by compression can develop gradually (if the metastasis compresses) or acutely (if compressed by a bone or its fragment).

Symptoms of compression occur suddenly. If such a symptom is detected at its initial stage, then its reversibility (at least partial) is quite possible. If you do not act during compression, then the paralysis becomes irreversible.

With timely therapeutic assistance, specialists are able to achieve a significant reduction in symptoms, although only 10% of cancer patients with paralysis can move independently after treatment.

How to determine bone metastases?

The most informative diagnostic method to identify bone metastases is skeletal, which allows you to accurately determine the extent and extent of metastasis.

A similar procedure can find metastases in any part of the human skeleton. Moreover, detection of the spread of tumor cells is possible at the very initial stages, when obvious disorders in bone structures are just beginning.

By using x-ray examination Bone metastasis can be detected only at the stage of sufficient maturity of the secondary formation, when about half of the bone mass has already been destroyed.

Photo of metastases in the hip bones on x-ray

But such diagnostics make it possible to differentiate the specific type of metastasis. Light white spots indicate blastic metastases, while gray-white spots indicate the lytic type of metastases.

Radioisotope diagnostics or osteoscintigraphy is carried out using the radiopharmaceutical Rezoscan, which is administered to the cancer patient approximately a couple of hours before the scan.

Diagnostics may also include MRI, detection of resorption markers in urine, blood tests, etc. If metastasis is detected in the cranial bones, then oncologists recommend carefully examining all organs to exclude the possibility of damage to them.

Are they being treated?

Metastasis to the cranial bones is observed mainly in renal or thyroid cancer, and their treatment can be carried out using a variety of methods:

• Surgical interventions are performed for palliative therapy and are necessary for various types of complications (compression, fractures, etc.). After the operation, pain is eliminated, bone marrow or limb functions are restored, etc.
• and in case of bone metastasis, it is used in complex conservative treatment, as well as in preoperative or postoperative period. These techniques allow you to destroy cancer cells and prevent their proliferation.
• Treatment with bisphosphonates. These medications slow down the processes of disorders in bone structures.
• Radiopharmaceuticals, when administered, lead to the destruction of active cancer cells.
• involves the use of special means to increase the body’s resistance so that the immune system resisted the spread of tumor throughout the body.

Video about drugs for the treatment of bone metastases:

Treatment with bisphosphonate drugs

Bisphosphonates are medications that prevent bone loss. They are designed to inhibit osteoclast activity and prevent bone destruction.

At the site of secondary tumor growth, bisphosphonates are absorbed by osteoclast cells, causing them to slow down or stop their activity. In addition, the use of bisphosphonates prevents the synthesis of osteoclasts, which become early dying or self-destructing.

Bisphosphonates are divided into 2 groups. One group of drugs contains nitrogenous compounds and is more effective against metastatic tumors. These include drugs like Ibandronate, Alendronate, Pamidronate, etc. The other group does not contain nitrogen, for example, Clodronate, Tidronate, etc. These drugs differ in less therapeutic effect.

Bisphosphonate drugs penetrate into the bone mass, accumulate around osteoclasts and begin to inhibit them, which leads to a decrease in the destructive activity of these cells. As a result, the processes of bone destruction are stopped.

Prognosis and life expectancy

Final prognosis depends on the location of the primary cancer.

1. If bone metastases are formed from lung cancer, the patient will live for about six months.
2. If the primary focus is located in the prostate, then life expectancy will be about 1-3 years.
3. If the source of metastasis to bone structures is a breast cancer tumor, then life expectancy will be approximately 1.5-2 years.
4. Kidney cancer with metastases to the bone leaves the cancer patient about a year to live.
5. With bone metastasis, life expectancy will be no more than six months.
6. If it spreads to bone tissue, life expectancy will be about 4 years.

Bone metastasis is extremely dangerous. If it is detected in a timely manner, there is a high probability of saving the cancer patient’s life.

20.10.2018

Bone metastases are an unpleasant and life-threatening situation, but they are not a death sentence.

With timely detection of metastases, the patient’s chances of saving life and the possibility of full functioning are increased.

Cancer metastases to bone are complications oncological diseases. When diagnosed, the pathology has last stage. If the disease is in an advanced form, when metastases are deep in the bones, then the patient’s life expectancy ranges from several months to a year.

Experts say that in most cases, bone metastases are formed as a result of cancerous tumors in digestive system, cervix, ovaries and soft tissues.

The process of metastasis is the penetration of cancer cells and reaching any organs and tissues, including bone, through the blood supply (lymphatic vessels).

Symptoms of bone metastases

In the first stages, the development of secondary bone tumors occurs without obvious signs. But over time, the following symptoms appear:

• hypercalcemia;
• tendency to pathological fractures;
• spinal compression.

Hypercalcemia is a dangerous complication, found in approximately 40% of patients with bone metastases. This condition may occur due to increased activity osteoclasts, which increase the level of calcium in the blood, and as a result cause an abnormal increase in renal excretory abilities.

In addition to hypercalcemia, hypercalciuria may develop, and impaired reabsorption of fluid and sodium may occur, which leads to polyuria.

Due to such changes, the patient experiences disruption of the functioning of many organs and systems:

• Nervous system. In the nervous system activity, signs are noted in the form of lethargy and mental disorder, as well as confusion in consciousness.
• Cardiovascular. The occurrence of arrhythmia and decreased blood pressure, decreased heart rate and increased risk of cardiac arrest.
• Digestive system. Nausea, vomiting, intestinal obstruction, and lack of appetite are observed.

In the case of bone metastasis and destruction of more than half of the cortical layer, pathological fractures occur. They are usually found in the bone tissue of the spine and hip bones. A fracture can occur even in low-traumatic situations, such as an awkward turn or a weak blow.

In most cases, such fractures occur for no externally visible reason. With a pathological fracture, bone fragments are displaced, which leads to impaired functionality of the limbs (if the fracture is localized on a long tubular bone) and neurological disorders (if localized on a vertebral structure). All this significantly affects the patient’s quality of life.

With tumor compression, the following symptoms are observed: increasing pain, weakness in muscle tissue, impaired sensitivity, dysfunction of pelvic organs, paralysis (in later stages).

If metastases have penetrated into the spinal tissues, patients sometimes experience spinal compression. A similar phenomenon is observed with metastases in the thoracic vertebrae. Disorders caused by compression can develop acutely (if the bone or its fragment is compressed) or gradually (if it is compressed by metastasis).

Signs of compression appear suddenly. If these symptoms are found on initial stage development, then reversibility is possible (in most cases partial). If you do not act on compression, the paralysis will become irreversible.

Diagnostics

Used for diagnosis various methods research:

• Radiography is the simplest and most accessible diagnostic method. The main disadvantage of using x-rays is the inability to detect pathology at the first stage.
• Computed tomography is a method in which a specialist obtains information about the extent and boundaries of bone damage through digital processing.
• Magnetic resonance imaging is irradiation using radiological waves, which determines the extent of bone tissue damage by metastases.

• Scintigraphy is a study that allows you to establish the localization of metastases.
• Biopsy followed histological examination- a method as a result of which it is possible to determine whether bone tissue belongs to a certain type. Thanks to this study an accurate diagnosis is made.

Treatment of bone metastases

If metastases are treated on time, malignant foci form less frequently, which increases the patient’s survival.

Also, skeletal complications manifested pain syndrome, pathological fractures, spinal cord compression and hypercalcemia occur less frequently and the patient's life becomes much easier, which is an important achievement.

Systemic drug therapy includes antitumor treatment (the use of immunotherapy and hormonal therapy) and supportive therapy (the use of bisphosphonates and analgesics). Local treatment is also possible with radiation therapy, surgery, radiofrequency ablation and cementoplasty.

Treatment tactics for patients with bone metastases are determined on an individual basis. The choice depends on the course of the disease, the age of the patient and the location of the metastases.

Treatment with bisphosphonate drugs

Bisphosphonates are medications that prevent bone loss. They are prescribed to suppress osteoclast activity and prevent bone destruction.

At the site of development of a secondary neoplasm, bisphosphonates are absorbed by osteoclast cells, which stops or slows down the activity of malignant cells. Bisphosphonates also prevent osteoclast synthesis.

Bisphosphonates are divided into two groups. The first group contains a nitrogenous compound and is the most effective against metastatic tumors (drugs: Ibandrotan, Alendronate, Pamidronate). The second group does not contain nitrogen and has less therapeutic effect (drugs: Clodronate, Tidronate).

Prognosis and life expectancy

Experts determine the incidence of metastases in skeletal system in patients suffering from cancer, according to it:

1. In lung oncology, metastases occur in 30-40% of cases, survival is about six months;
2. In breast cancer, metastases form in 60-70% of cases, survival after detection of metastasis ranges from one and a half to two years;
3. In prostate cancer, the frequency of metastasis ranges from 50-70% of cases, survival is about three years.
4. In kidney cancer, the incidence of metastases is 20-25%, survival rate is about one year;
5. For thyroid cancer in 60-70% of cases, the survival meridian is four years;
6. In melanoma, the formation of metastases is 15-45%, survival rate is no more than six months.

Prevention

Key point in prevention of this disease– this is a timely diagnosis of the primary neoplasm. This allows you to start treatment on time and stop the process of proliferation of malignant cells and their damage to other systems and organs.

An important role is played by the correct choice of treatment, which is aimed at destroying cancer foci and increasing the body’s resistance to diseases.

To reduce the risk of developing bone metastases, you must strictly follow all the recommendations of your doctor regarding physical activity, diet, and intake. medicines and so on.

Bone metastases are a serious complication of oncology, accompanied by unpleasant symptoms. At timely diagnosis the quality and life expectancy of the patient increases.