Treatment


The management for bone metastases depends largely on the degree of bone damage once the metastases are diagnosed. An initial step in managing bone metastases is often controlling the associated pain, which can be accomplished with pain medications, bisphosphonate drugs, or radiation therapy. Radiation therapy may also be used to kill the cancer cells in the bone in patients whose bones have not already been weakened. If bone metastases have progressed to the point that the bones are unstable or fractured, surgery may be necessary to stabilize them.
Prevention of bone metastases may be possible in some patients who are at high risk of developing bone metastases through treatment with bisphosphonate drugs. Bisphosphonate drugs can effectively prevent loss of bone that occurs from metastatic bone damage, reduce the risk of fractures, and decrease pain.
The following is a general overview of treatment and prevention for bone metastases. Treatment may consist of pain medication, bisphosphonate drugs, radiation therapy, surgery, or a combination of these treatment techniques. In some cases, participation in a clinical trial utilizing new, innovative therapies may provide the most promising treatment. Circumstances unique to each patient's situation may influence how these general treatment principles are applied. The information on this website is intended to help educate patients about their treatment options and to facilitate a mutual or shared decision-making process with their treating cancer physicia
Radiation Therapy in the Treatment of Bone Metastases
For metastatic lesions that do not represent an immediate risk of fracture, radiation is effective for reducing bone pain and progression of the cancer. Radiation is especially useful when metastatic lesions are limited to a single area.
One type of radiation therapy is called radiopharmaceutical therapy. This approach involves injecting a radioactive substance, such as strontium-89, into a vein. This substance is attracted to areas of bone that contain cancer. Providing radiation directly to the bone in this way destroys active cancer cells in the bone and can relieve symptoms. Two possible side effects of radiopharmaceutical therapy are decreased blood counts with increased risk of bleeding, and rarely, leukemia.
Surgery in the Treatment of Bone Metastases
When there is an immediate or significant risk of fracture, surgery may be necessary to stabilize the weakened bone. Metal rods, plates, screws, wires, nails, or pins may be surgically inserted to strengthen or provide structure to the bone damaged by metastasis.
Strategies to Improve Treatment and Prevention of Bone Metastases
The development of more effective cancer treatments requires that new and innovative therapies be evaluated with cancer patients. Clinical trials are studies that evaluate the effectiveness of new drugs or treatment strategies. Future progress in the treatment and prevention of bone metastases will result from the continued evaluation of new treatments in clinical trials. Participation in a clinical trial may offer patients access to better treatments and advance the existing knowledge about treatment of this cancer. Patients who are interested in participating in a clinical trial should discuss the risks and benefits of clinical trials with their physician. Areas of active investigation aimed at improving the treatment of bone metastases include the following
    

 

  
     

2007 Dreamers