Bone metastases

What are bone metastases?

Bone is continually being transformed throughout our lives. The breakdown and new growth of bone are closely linked to one another. About eight per cent of the entire skeleton is renewed in this way each year.

Breakdown and regeneration of bone are in equilibrium in a healthy individual. But this balance can be disrupted in cancer.

Almost 300,000 people develop various forms of cancer in Germany every year. Bone metastases occur frequently in some forms of malignant disease, and relatively rarely in others.

In some cases, migration of cancer cells occurs even in the early stages, and these cells may migrate to the bones.

What are the causes of and risk factors for developing bone metastases?

If the cancer is metastatic, cancer cells may also migrate into the bones. Bone metastases originate from mutated cells in other tissue that have colonised the bones. Their unchecked growth disturbs the natural balance between growth and breakdown and the function of the bone. Most patients with bone metastases suffer from severe bone pain.

What role does lifestyle play in bone metastases?

Even minor accidents, such as falls or knocks, can result in “pathological fractures” - i.e. broken bones. It is therefore extremely important for the patient to take special care.

How are bone metastases diagnosed?

Bone metastases are usually detected by means of a radiological examination. X-ray imaging is used for the initial examination and to monitor the progress of the disease.

Other radiological procedures that may be used:

  • Computed tomography
  • Magnetic resonance imaging
  • Bone/skeletal scintigraphy

Skeletal scintigraphy (bone scan)
Skeletal scintigraphy is a special form of radiological diagnostic tool. Small quantities of a radiolabelled substance are injected into a vein. For a brief period, the substance accumulates in areas of bone with increased activity, thus making these areas visible.

Bone biopsy
Taking a sample of bone marrow enables accurate investigation of bone tissue, mineralisation and bone cells.

How are bone metastases treated?

The aim of treatment is to strengthen the bones, prevent potential fractures and alleviate bone pain.

Various therapeutic measures may be used:

Surgery
In the event of a potential fracture or one that has already occurred, the bone needs to be stabilised surgically.

Radiotherapy
The cancer cells are destroyed or their growth is prevented using high-energy x-rays. This form of treatment is especially suitable if bone metastases can only be detected in a limited area.

Chemotherapy
This therapy is always used if cancer cells are present throughout the body, i.e. including the bones. The cells are destroyed using drugs.

Bisphosphonate therapy
Bisphosphonates are an established option for the prevention of bone fractures resulting from bone metastases. They accumulate in the bones where they combat the breakdown caused by bone metastases.