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Treating Bone Metastasis

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Side effects of hormone therapy for breast cancer may include:

  • Blood clots
  • Uterine cancer

Bisphosphonates for Bone Metastasis

This group of drugs works best in cases where metastasis is weakening the bone (osteolytic).

How it works. You receive bisphosphonates by IV infusion every three to four weeks. These drugs help with bone mets by:

  • Slowing bone damage and reducing the risk of bone fractures
  • Reducing bone pain
  • Reducing high levels of calcium in the blood

Possible side effects. The most common side effects of bisphosphonates include:

  • Fatigue
  • Fever
  • Nausea or vomiting
  • Anemia
  • Bone or joint pain

A rare and serious side effect is osteonecrosis (bone death) of the jaw. Ask your doctor about precautions to take before beginning this treatment. Osteonecrosis may cause:

  • Jaw bone pain, swelling, or numbness
  • Loss of gum tissue
  • Loose teeth
  • Infection

Another available treatment is denosumab (Xgeva). Denosumab is given by injection, and may work as well or better than bisphosphonates to prevent fractures. But it also can cause osteonecrosis, as well as low calcium levels in the blood.

Radiopharmaceuticals for Bone Metastasis

Radiopharmaceuticals are drugs that contain radioactive elements that target cancer cells. Doctors tend to use this systemic treatment when the metastasis is stimulating new bone growth. This is more common with prostate cancer.

If your cancer has spread to many bones, these drugs may be a better option than standard radiation therapy, which uses an external beam to aim radiation at each bone metastases. However, sometimes doctors combine radiopharmaceuticals and external beam radiation.

How it works. The doctor injects a single dose of the drug into a vein. It then travels to the areas of bone with cancer and gives off radiation to kill the cancer. This single dose may be effective against pain for several months. You can receive another treatment later.

Possible side effects. The most common side effects of radiopharmaceuticals include:

  • Infections
  • Bleeding
  • Temporary increase in pain (flare reaction)

Immunotherapy for Bone Metastasis

This systemic therapy helps your immune system spot and more effectively kill cancer cells. Some methods of immunotherapy have been used for a while and some are still experimental.

How it works. Immunotherapy works in one of two main ways:

  • It boosts your body's immune system to fight the cancer.
  • It uses a manmade version of proteins to kill cancer cells.

Examples of immunotherapy for cancer include:

  • Cytokines -- substances secreted by the immune system that have an effect on other cells
  • Monoclonal antibodies -- a class of antibodies produced in the lab from a single population of cells
  • Tumor vaccines – vaccines using a substance that prompts the immune system to respond to a tumor

Possible side effects. Side effects vary, depending upon the type of immunotherapy. They may include:

  • Fever and chills
  • Weakness
  • Headache
  • Nausea or diarrhea
  • Rashes

WebMD Medical Reference

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