Metastatic Bone Tumors

Metastatic bone tumors are cancers that have spread to the bone from their original site elsewhere in the body (see Section 15, Chapter 180). Cancers most likely to spread to the bone include those of the breast, lung, prostate gland, kidney, and thyroid gland. Cancer may spread to any bone but usually does not spread beyond the elbow and knee.

A person who has or has had cancer and develops bone pain or swelling usually is examined for metastatic bone tumors. Bone scans using radioactive tracers and x-rays can help locate these tumors. Occasionally, a metastatic bone tumor produces symptoms before the original cancer has been detected. Symptoms may consist of pain or a fracture where the tumor has weakened the bone (a pathologic fracture). In these situations, a biopsy usually gives clues as to the location of the original cancer, because the type of tissue from which the cancer derived can often be recognized under the microscope.

Treatment depends on the type of cancer that has spread to the bone. Some types respond to chemotherapy, some to radiation therapy, some to both, and some to neither. Surgery to stabilize the bone can sometimes prevent fractures. When the original (primary) cancer has been removed and only a single metastasis in the bone remains, surgical removal combined with radiation therapy, chemotherapy, or both is sometimes curative.