Metastatic Bone Tumors of the Skeleton

Summary

Metastatic bone tumors of the skeleton are caused when cancer from another part of the body spreads to the bones. Cancer spreading to the bones from elsewhere is much more common than cancer that begins in the bones (primary bone tumors).

The most common kinds of metastatic bone tumors of the skeleton begin with prostate, breast, thyroid, lung, or kidney cancer. They are most often found in the bones containing blood-forming marrow such as the spine, ribs, skull, pelvis, and the ends of long bones especially the femur and humerus. Rarely metastases to the hands or feet occur. In children, metastatic skeletal tumors are usually due to neuroblastoma, leukemia or Ewing's sarcoma. In teenagers or young adults, lymphoma is the primary disease. Metastases after age 30 are usually adenocarcinoma (a type of cancer that involves the cells lining the walls of different organs in the body). Metastatic tumors from the kidney or thyroid are usually very vascular (made of blood vessels) whereas tumors from prostate, breast and lung are less so. With many patients, the primary tumor is not identified, so staging studies and biopsy are necessary to rule out a primary malignant bone tumor. Sometimes a primary site is never identified. In patients with a history of cancer, a bone scan will show any additional sites of skeletal involvement.

Most patients with bony metastases present with pain in the area of the lesion with decreased mobility and motion. Staging studies are usually done to determine the extent of the metastatic disease and plan the most appropriate treatment. Pain control and surgical internal fixation to provide bone stability are the major goals of treatment. Chemotherapy, use of hormones and palliative radiation therapy, that is radiation to treat the symptoms not cure, are other options used to care for patients with metastatic disease.

Metastatic disease is very serious, but advances in cancer care mean that many patients still have significant amounts of quality time for themselves and their families. Recent advances in cancer management has made that possible. These patients living with metastatic disease have a phenomenal amount of inner strength and hope.