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Bone Metastasis: What Happens

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Signs and Symptoms of Bone Metastasis

Bone metastasis can cause major pain. "It is more painful in a weight-bearing bone than in other bones," Fasano says. For example, a metastasis in the hipbone might be more painful than one in a rib bone.

At first, it may be hard to tell what's causing your symptoms. "And it may be hard to remember that not all pain is caused by the cancer," Fasano says. So it's important to tell your doctor right away if you have any of these symptoms of bone metastasis:

  • Bone pain. This is often the first symptom of bone mets. It may come and go at first. It is often worse at night and gets better with movement. However, over time, the pain doesn't go away.
  • Broken bones.  This occurs because bone metastases weaken bone and puts you at risk for fracture. Breaks are most common in the leg, arm, or a bone in the spine.
  • Numbness, paralysis, or trouble urinating. Pressure on the spinal cord from bone metastases in the spine can cause this.
  • Loss of appetite, nausea, extreme thirst, confusion, or tiredness. These symptoms may be due to high levels of calcium in the blood. As metastasis develops in the bone, there is release of calcium into the bloodstream.

If you have symptoms, your doctor will likely want to do a thorough physical exam, blood tests, and a bone scan. Depending upon the lab test results and where and how severe the bone pain is, Fasano says she often orders an X-ray or a PET or CT scan. To confirm the diagnosis, the doctor may take a biopsy of tissue to look at under a microscope.

Types of Treatment for Bone Metastasis

How doctors treat bone metastasis depends on the extent and location of the bony lesions, Fasano says. Treatments include:

  • Treating the underlying cancer. This is the most important step, Fasano tells WebMD. Treatment depends on the type of tumor and where it started in your body. Treatment often includes a combination of drugs that were used to treat the primary cancer when you were first diagnosed.  
  • Bisphosphonates. Bisphosphonate drugs such as Aredia and Zometa help prevent the breakdown of bone, which can ease pain and reduce your risk of fractures. Doctors will infuse bisphosphonates through an IV "every four weeks to halt or slow the progression of metastasis formation and to help prevent breaks," says Fasano.

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