Metastatic Bone Tumors of the Skeleton
Metastatic bone tumors of the skeleton are malignant bone tumors caused by the spread (metastatic disease) of another type of cancer, greatly outnumber the primary (original site) malignant bone tumors. Most of these bone metastases are from prostate, breast, thyroid, lung or kidney cancers. The most common sites for skeletal (bony) metastases are 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.
It is important to note that many patients have a significant amount of quality time for themselves and their families despite living with metastatic disease. Recent advances in cancer management has made that possible. These patients living with metastatic disease have a phenomenal amount of inner strength and hope.