In recent years, the incidence rate of malignant tumor has been on the increase in China with over 3 million new cancer patients diagnosed each year. 80% of the diagnosed patients need to receive cancer rehabilitation and palliative treatment, including pain control, bone metastases treatment, nutrition and psychological support, etc. Among the numerous factors that can adversely affect patients’ quality of life, bone metastasis is the most notorious one.
Bone metastasis refers to the situation when cancer cell transfers to bones through blood circulation, grow in local bone and further cause bone destruction. Bone metastasis tends to occur in spine, pelvis, ribs and other parts and causes osteodynia, pathological fracture that is not caused by fall or collision, hypercalcemia. Bone metastases can also lead to spinal cord compression that further causes paraplegia.
Bone metastasis is commonly seen in patients with nasopharynx cancer, breast cancer, prostate cancer, lung cancer, kidney cancer, etc. Among them, the incidence rates of bone metastasis in nasopharynx cancer, breast cancer, prostate cancer are the highest and are 67%-75% in nasopharynx cancer and 65%-75% in breast cancer and prostate cancer; the next is thyroid cancer (60%), lung cancer (30-40%), kidney cancer (20%-25%). Bone metastasis doesn’t pose direct threat to life, but the symptoms it causes inflict much pain to patients and seriously impact their quality of life.
Further checkup should be done once osteodynia is felt
Osteodynia tends to be the first symptom of bone metastasis from malignant tumor or the first alert that rings bone metastasis clinically. Patients who have been diagnosed with malignant tumors should receive further examination to rule out bone metastasis once such clinical manifestation as osteodynia, pathological fracture, spinal cord compression, hypercalcemia are detected. Patients who have malignant tumors (such as breast cancer, lung cancer, prostate cancer, nasopharynx cancer) that stand high risk of developing bone metastasis should consider including clinical examination for bone metastasis into one of the routine examination items. The screening methods for bone metastasis mainly include imaging examinations as below:
1. ECT: ECT serves as the preliminary screening method for bone metastasis from malignant but cannot be counted as diagnosis basis.
2. X-Ray examination: X-Ray examination is the major method for diagnosing bone metastasis but its sensitivity to early bone metastases is lower, only about 44%-50%.
3. CT scan: CT scan, another diagnostic method for bone metastasis, stands higher sensitivity than X-ray examination.
4. MR scan: MR scan for bone metastasis stands high sensitivity, reaching up to 82%-100%. It enjoys special advantage in showing early metastasis in marrow cavity.
Comprehensive treatment can prolong patients’ life
Once bone metastasis is detected, many patients believe that cancer has developed to its advanced stage and it doesn’t make much sense to continue with treatment; some patients even give up treatment. However, these ideas are wrong. The occurrence of bone metastasis doesn’t mean that cancer has developed to its last phase. In the past, due to a lack of consensus on bone metastases among different disciplines, much attention is only paid to reduce patients’ pain but most patients died in extreme agony due to intense pain, prolonged chronic exhaustion and depression. Fortunately, the development of modern science has significantly updated people’s understanding of diagnosis and treatment for bone metastases.
At present, the goals of bone metastases treatment is to reduce pain, prevent, reduce or put off the occurrence of skeletal related event. Patients have gained longer survival time and significantly improved quality of life, some patients could even get back to their work.