Bone Metastasis - Diagnosis & Treatment

How is bone metastasis and bone cancer diagnosed?

Your doctor may order certain tests to check for bone cancer and determine how far the cancer has spread. These tests include:

X-ray

If you have bone pain and other bone symptoms, an X-ray is often one of the first tests you will go for. An X-ray can help reveal signs of cancer in the bones.

Bone scan

A bone scan can show the entire skeleton. It can usually detect bone cancer earlier than regular X-rays. It is also used to monitor how much the cancer has spread.

Computerised tomography (CT scan)

A CT scan may be necessary in checking for cancer, which is sometimes unable to be detected by a bone scan. A CT scan is also ideal for checking the size and shape of a tumour in the bone.

Magnetic resonance imaging (MRI)

Like the CT scan, MRI produces detailed cross-sectional images of the body. It is the standard test that doctors require if spinal cord compression is suspected. It is also useful in evaluating the extent of soft tissue involvement.

Positron emission tomography (PET)

A PET scan can provide detailed information on the function of an organ or system in your body such as the chemical and physiological changes related to metabolism. This is important because these functional changes often occur before structural changes in tissues can be seen, and PET images are able to show abnormalities long before they would be revealed by an X-ray, CT scan or MRI.

Biopsy

A biopsy is needed to determine whether the lesion is cancerous or not. It also reveals whether the lesion is a primary bone cancer or a bone metastasis.

How is bone metastasis and bone cancer treated?

The treatment of bone cancer depends on several factors such as the stage of bone cancer, history of past treatment, age and general health. Bone cancer may be treated with a combination of treatment options.

The goal of treatment is to remove the whole cancerous lesion if possible. If the cancer is very advanced, treatment may aim to ease the cancer-related symptoms and control further growth of the cancer.

Treatment of bone cancer

The treatment plan may include:

• Chemotherapy – This treatment makes use of strong chemicals to get rid of fast-growing cells in the body. It is one of the treatments that may be given if cancer has spread to multiple bones. Chemotherapy can be taken as a pill, administered through the vein, or both.
• Radiation therapy – Using high-powered energy beams like X-rays and protons to destroy cancer cells, radiation therapy is one of the treatment options if bone cancer is causing pain that can't be relieved by medications or if the pain is confined to a small number of areas.
• Surgery – Surgery may be recommended by your doctor to remove the entire cancerous tumour. If your cancer is in an arm, leg, shoulder or hip, your surgeon may want to do a limb sparing surgery. This means removing the cancer, but not the whole arm or leg. In some cases, amputation or removal of the entire limb or part of it may be necessary if the bone cancer is very large or if it extends into the nerves and/or the blood vessels, making it impossible to salvage the limb.