When Renal Cell Carcinoma Spreads to Your Bones

When renal cell cancer is “metastatic,” that means it has spread from your kidney to other parts of your body. Bones are a common place for this cancer to travel.

It's harder to treat the disease once it has spread to your bones -- but it's not impossible. There are therapies that target cancer cells anywhere in your body. Other treatments strengthen your bones and help you feel better overall.

How Cancer Affects Your Bones

When cancer spreads to your bones, it can cause pain and make them weak enough to fracture. When bones break, they release calcium into your blood. If too much builds up, you could get a dangerous condition called hypercalcemia.

Treatments for Cancer in Your Bones

Some treatments shrink the cancer. Others protect your bones from the damage the cancer can cause. And some therapies ease your symptoms to help you feel better.

Targeted therapy. These medicines go after substances that help cancer cells grow and survive. They’re designed to kill cancer without harming healthy cells.

Tyrosine kinase inhibitors (TKIs) target proteins that help cancer cells and their blood vessels grow. These drugs include:

  • Cabozantinib (Cabometyx)
  • Pazopanib (Votrient)
  • Sorafenib (Nexavar)
  • Sunitinib (Sutent)
  • Axitinib (Inlyta)
  • Lenvatinib (Lenvima)

Bevacizumab (Avastin) is another type of targeted therapy. It blocks a protein called VEGF, which helps tumors grow new blood vessels.

mTOR inhibitors target the mTOR protein, which helps cancer cells grow. They include everolimus (Afinitor) and temsirolimus (Torisel).

Immunotherapy. Also called biologic therapy, these medicines use substances made in a lab or by your body to fight kidney cancer. There are a few types:

  • Interleukin-2
  • Interferon alpha
  • Checkpoint inhibitors, such as nivolumab (Opdivo)

Radiation. In this treatment, a machine beams high-energy X-rays to kill cancer cells inside your body. It can relieve pain in your bones. It also can prevent weak bones from breaking. If you already have a fracture, killing cancer cells with radiation will help it heal faster.

Surgery to remove cancer from your bone can relieve pain, prevent fractures, and make it easier for you to move around.

Drugs to strengthen bones. A few medicines can make bones stronger, and prevent pain and fractures.

  • Bisphosphonates. Drugs like zoledronic acid (Zometa) slow the work of cells that break down bones. They can slow bone damage, prevent fractures, and lower the amount of calcium in your blood.
  • Denosumab (Xgeva). Like bisphosphonates, it helps prevent bone breakdown and fractures.

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How to Manage Your Symptoms

Palliative care can relieve symptoms like pain, fatigue, and nausea. This treatment won't cure your cancer, but it can help you feel better. You can still get your other cancer treatments while you're getting palliative care.

Palliative care can include:

  • Surgery
  • Radiation
  • Pain relievers and other medicines
  • Relaxation techniques
  • Emotional support

Ask your doctor if your hospital or cancer center offers palliative care services.

Living With Cancer in Your Bones

It’s natural to feel worried or afraid if you know that your cancer has spread to your bones. Make sure you understand all of your treatment options. Ask for a second opinion if you're not sure about the treatment your doctor has recommended.

If you've tried several treatments and they haven't stopped your cancer, ask your doctor about enrolling in a clinical trial. These trials test out new treatments for renal cell cancer. They are often a way to try a new therapy that isn't available to everyone. Your doctor can tell you if one of these trials might be a good fit for you.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on September 11, 2017

Sources

SOURCES:

Acta Orthopaedica: "Surgery of non-spinal skeletal metastases in renal cell carcinoma."

American Cancer Society: "If Treatment for Kidney Cancer Stops Working," "Surgery for Kidney Cancer," "Targeted Therapies for Kidney Cancer," "Treating Bone Metastases."

Cancer.Net: "Caring for the Symptoms of Cancer and Its Treatment," "Hypercalcemia," "Kidney Cancer: Treatment Options."

Journal of Kidney Cancer and VHL: "Management of metastatic renal cell carcinoma -- mini review."

Kidney Cancer Association: "Therapies for Advanced Kidney Cancer."

Therapeutic Advances in Medical Oncology: "Renal cell carcinoma bone metastases: clinical advances."

University of New Mexico: "Stage IV Renal Cancer."

U.S. National Library of Medicine: "Bevacizumab Injection."

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