By Donald Gajewski, MD
Lots of people have achy bones and joint pain, but for people who either have cancer or have been previously treated for cancer, it could be a sign of a very serious condition known as metastatic bone disease. In fact, if you have been treated for cancer in the past and you’re experiencing new bone pain that doesn’t go away or worsens with mild to moderate use, you should notify your primary care doctor or medical oncologist.
Metastatic bone disease (MBD) is when cancer spreads from its original site to bone. Although most cancers can spread to bone, it is most commonly seen in breast, lung, thyroid, kidney and prostate cancers. And though MBD can occur in any bone, it most commonly arises in the spine, pelvis, ribs, shoulders, knees and hips. Bone metastases can cause pain and fractures, significantly affecting the patient’s quality of life.
MBD may be the first sign that you have cancer, or it may occur many years after treatment of the primary cancer. The role of the musculoskeletal oncologist it to work with your medical oncologist and radiation oncologist to maximize your function and decrease your pain, to maintain the highest quality of life.
The most common symptom for MBD is pain, but sometimes bone metastases will cause no signs or symptoms. Pain is most likely caused from the weakening of the bone, and weakened bones are more likely to fracture. Your musculoskeletal oncologist may order X-rays, bone scans, CT scans or MRI’s to evaluate your risk of fracture.
In terms of treatment, patients with MBD require a team approach to care with a primary focus on managing the symptoms of pain and preventing spread of the disease. Although the most common treatment options include radiation and medications, surgery may be recommended to stabilize the bone if there is a high risk of fracture.