Bone Metastasis

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Bone metastasis, sometimes referred to as “bone mets," can weaken your bones and make everyday activities challenging and painful, but treatments can ease pain and improve your quality of life. Duke orthopaedic and cancer specialists work closely with you to determine the severity of your bone metastasis and recommend the most effective treatment. Our goals are to slow the spread of cancer in your bones, relieve your symptoms, and maximize mobility to help you live more comfortably.

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Committed to Your Quality of Life

Common Cancers That Spread to Bone
Bone metastasis is a secondary form of cancer that occurs when it spreads to your bones from a primary tumor. It is most commonly associated with breast, kidney, lung, prostate, and thyroid cancers, and certain forms of melanoma. Cancer can spread during your treatment for your primary cancer or years after you’ve completed treatment. If you are currently undergoing cancer therapy, we’ll integrate bone metastasis treatments into your current plan of care.

With You from the Start
From the moment your bone metastasis is diagnosed, our patient coordinator will guide you through what to expect. Their job is to make your visits as easy as possible. They’ll share your medical information with your doctors before your first appointment so you can have a productive first discussion and create the best care plan for you.

A Team Approach to Your Care
You’ll work with a team of experts who provide the full range of care. Doctors from our team, which include interventional radiologists, radiologists, radiation oncologists, and surgical oncologists, meet regularly to review the case of each patient being treated for bone metastasis. 

Setting Goals
Your bone metastasis may already affect your ability to move and maintain normal levels of activity. We’ll work with you to match treatment options to your goals, whether it's to walk unassisted, play golf, or live independently for as long as possible.

Duke Cancer Center

Duke Health providers treat your bone metastasis at the Duke Cancer Center in Durham.

What to Expect at Your First Appointment

During your first visit, you’ll have a physical exam to identify the greatest source of pain and help your doctor understand how your cancer impacts your daily life. You may also speak with specialists on our team who will review options for treatment. Additional imaging and tests may be ordered to get the most up-to-date information on how your cancer is spreading.
 
After your initial appointment, we’ll work with your referring oncologist to coordinate your treatment plan.

Tests for Bone Metastasis

You doctor will perform a comprehensive exam to evaluate your pain and the cancer’s effect on your bones. Previous X-rays will be reviewed, and additional imaging may be ordered to confirm the severity and extent of your bone metastasis. Our main goals are to assess your bone are functioning, help with pain management, and slow or stop the cancer’s growth in your bones.

Imaging Tests

Your doctor may recommend imaging tests for specific areas of your body, including additional X-rays and MRI, CT, and PET scans. These tests help determine the extent of the cancer in your bone and to look for any fractures. Another option is a whole-body bone scan, which is more powerful than a regular X-ray. It allows your doctor to see your entire skeleton at once to identify areas where cancer has spread to your bones.

Biopsy

A biopsy removes a small amount of tissue that is tested for the presence of cancer. In some cases, this test is not necessary. Your medical history and imaging test results may be all your doctor needs to confirm your diagnosis.

Treating Bone Metastasis

We consider many factors when making treatment recommendations. Your options may range from medication to surgery.

Medication

Bisphosphonates are drugs that lower the risk of broken bones. It may reduce pain, bone damage, and high blood calcium levels. This medication is typically given through an IV at one of our hospitals or clinics on a regular basis. Your doctor may also prescribe medicine with small amounts of radioactive elements that can slow the growth of cancer cells and relieve pain. 

Any medication will be ordered in coordination with your medical oncologist. Your oncologist may adjust your chemotherapy, hormone therapy, or immunotherapy for your primary cancer to accommodate your bone metastasis care. 

Radiation Therapy

Radiation therapy uses targeted beams to destroy or slow the growth of cancer cells, which can help preserve bone strength. If you're already being treated with chemotherapy for your primary cancer, that will continue.

Bone Ablation

During this minimally invasive procedure, a small needle or probe with an electrical current is inserted into the area of your cancer. It delivers heat (radiofrequency ablation) or cold (cryoablation) to halt or slow the spread of bone metastasis and to destroy nerves that cause pain. Your doctor may fill the remaining space around your bone with bone cement to provide pain relief and bone support. This can safely be done if you are receiving chemotherapy and/or radiation therapy.

Surgery

Surgery may be necessary to repair weak or broken bones or to remove bone damaged by cancer. Our team includes surgeons who specialize in orthopaedics and orthopaedic oncology. They are specially trained to preserve as much of your bone as possible. In some cases, we may use advanced techniques to reconstruct bone that was damaged by cancer. A common treatment during surgery is to stabilize your bone by placing a metal rod or plate on your damaged bone to prevent fracture and reduce pain.

Support for You and Your Family

Our cancer support services help you cope with the emotional and psychological effects of diagnosis and treatment.

Why Choose Duke

Experts in Bone Metastasis
Our doctors are focused on your needs. The number of experts on our team ensures you receive thorough, comprehensive care. Through in-person and telehealth appointments, inpatient consultations, and treatments, we make every effort to work with our patients and keep treatment on track.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

This page was medically reviewed on 07/13/2020 by