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Bone Metastases

Bone Metastases

What is bone cancer? — Bone cancer happens when normal cells in the bone change into abnormal cells and grow out of control. This article discusses cancer that starts in the bone. But people can also get cancer in their bones after cancer from another part of the body spreads to the bones. This is not called bone cancer. If the cancer started in the lung or breast, it is called metastatic lung or breast cancer.
There are different types of bone cancer, depending on the cells involved. The most common type is osteosarcoma. Other common types of bone cancer are chondrosarcoma and Ewing sarcoma.
What are the symptoms of bone cancer? — Bone cancer usually causes pain and swelling in the area of the cancer. The pain can come and go, but it usually gets worse over weeks to months. The pain is sometimes worse at night and with exercise. Some people with bone cancer might also see or feel a lump on their bone or in the tissues around the bone.
All of these symptoms can also be caused by conditions that are not bone cancer. But if you have these symptoms, tell your doctor or nurse.
Is there a test for bone cancer? — Yes. Your doctor or nurse will first order an X-ray of your bone.
If the X-ray shows that you might have bone cancer, you will have other tests. These will probably include:
Blood tests
An imaging test, such as an MRI or CT scan, of the area – An imaging test creates pictures of the inside of the body.
A full-body bone scan or PET scan or other imaging test, to check for bone cancer in other parts of your body.
A biopsy – This is a procedure in which a doctor removes a sample of the area suspected to have cancer. Then another doctor looks at the sample under a microscope.
What is cancer staging? — Cancer staging is a way in which doctors find out if a cancer has spread past the layer of tissue where it began, and, if so, how far.
The right treatment for you will depend a lot on the type of bone cancer you have, its stage, and your other medical problems.
How is bone cancer treated? — Depending on the type of bone cancer, treatment includes one or more of the following:
Surgery – In general, surgery is the main treatment for bone cancer. The type of surgery you have depends on where your cancer is and how big it is. In most cases, surgeons do "limb-sparing" surgery. This is when the surgeon removes the cancer without removing the arm or leg where the cancer is growing. Depending on the type of surgery, the doctor might need to "rebuild" part of a bone after surgery.
Sometimes, when bone cancer is growing in an arm or leg, surgery might need to involve an amputation. This is when the surgeon removes all or part of the arm or leg along with the cancer. After an amputation, some people use a prosthesis, which is a man-made arm or leg.
Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing. Most people with bone cancer have chemotherapy before and after their surgery.
Radiation therapy – Radiation kills cancer cells. Doctors might use radiation when people can't have surgery or when all of the cancer can't all be removed safely with surgery.
What happens after treatment? — After treatment, your doctor will check you every so often to see if the cancer comes back. Follow-up tests can include exams, blood tests, chest X-rays, and imaging tests.
You should also watch for the symptoms listed above. Having those symptoms could mean your bone cancer has come back. Tell your doctor or nurse if you have any symptoms.
What happens if my bone cancer comes back or spreads? — If your bone cancer comes back or spreads, you might have more surgery, radiation, or chemotherapy.
What else should I do? — It's important to follow all of your doctor's instructions about visits and tests. It's also important to talk to your doctor about any side effects or problems you have during treatment.
Getting treated for bone cancer involves making many choices, such as what treatment to have. Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:
What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
What are the downsides to this treatment?
Are there other options besides this treatment?
What happens if I do not have this treatment?
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83150 Version 5.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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