Bone Cancer Treatment Metastases
Treating Bone Metastases
Treatments can often shrink or slow the growth of bone metastases and can help with any symptoms they cause. But they usually do not make the metastases go away completely. Some people believe that nothing more can be done if the cancer can’t be cured, so they stop all treatment. But radiation, chemotherapy (and other drugs), surgery, and other treatments can often slow cancer growth and help control symptoms. And relieving symptoms like pain and constipation can help you feel better. Something can almost always be done to help maintain or improve your quality of life.
At any stage of cancer, the goal of treatment should be clear. You should know if the goal is to cure the cancer, slow its growth and help you live longer, or relieve symptoms. This can sometimes be confusing because some treatments used to cure cancer are also used to slow its growth or relieve symptoms.
Treatment options for people with bone metastases depend on many things:
- What kind of primary cancer you have
- Which bones (and how many) the cancer has spread to
- Whether any bones have been weakened or broken
- Which treatments you have already had
- Your symptoms
- Your general state of health
Systemic treatments (which go through the whole body) and local treatments (which treat only the cancer in the bone) are the 2 main types of treatment for bone metastases Depending on the extent and location of the metastases, one or both of these types of treatment may be used.
Systemic treatments for bone metastases.
Systemic treatments affect the whole body. In many cases, especially if the cancer has spread to many bones, systemic treatments are used because they can reach cancer cells all through the body.
Systemic therapies include chemotherapy, hormone therapy, or other medicines that are taken by mouth or injected into the blood. These treatments are not aimed specifically at bone metastases, but they often help treat them.
Other systemic treatments, such as radiopharmaceuticals and bisphosphonates (see sections below), are aimed more specifically at cancer that has reached the bones. Sometimes both of these types of treatments are used at the same time.
Chemotherapy (chemo) uses drugs that are injected into a vein or taken by mouth to kill cancer cells. These drugs enter the bloodstream and go throughout the body. Chemo is used as the main treatment for many types of metastatic cancer. It can often help shrink tumors, which can reduce pain and help you feel better, but it doesn’t make them go away and stay away. It’s sometimes used with local treatments such as radiation.
Hormone therapy drugs block the actions of certain hormones or reduce how much is made. This therapy is most often used to treat breast and prostate cancer, and it can be used when these cancers spread to the bone as well.
For instance, estrogen is a hormone that causes many breast cancers to grow. Drugs can lower estrogen levels or block the effect that estrogen has on breast cancer cells. When breast cancer has spread to the bones, this may stop cell growth and even cause tumors to shrink.
Likewise, male sex hormones, called androgens, make most prostate cancers grow. Drugs that lower androgen levels or block their effect can help stop or slow growth of these cancers.
Targeted therapy drugs attack specific parts of cancer cells or other cells or proteins that help cancer cells grow. These drugs work differently from standard chemo drugs. They can be used alone or along with other treatments to treat bone metastases.
Immunotherapy is a systemic therapy that boosts the body’s immune system or uses man-made versions of immune system proteins to kill cancer cells. Immunotherapy may be used to treat bone metastases.
Radiopharmaceuticals are a group of drugs that carry radioactive elements. These drugs are injected into a vein and settle in areas of bone with active turnover (like those containing cancer spread). Once there, the radiation they give off kills cancer cells.
If cancer has spread to many bones, radiopharmaceuticals work better than trying to aim external beam radiation at each affected bone. (External beam radiation is discussed below as a local treatment.) In some cases, radiopharmaceuticals may be used along with external beam radiation that’s aimed at the most painful bone metastases.