Metastatic spread of breast cancer to the bones
Metastatic breast cancer (MBC) is a challenging condition, but it doesn't mean that individuals cannot live full lives during treatment. In fact, MBC is the most common cancer among women in the United States, and advancements in treatment have significantly improved outcomes for those affected.
When breast cancer spreads to the bones, common symptoms include bone pain (often a dull ache worsening at night), increased risk of bone fractures even with minor injuries, numbness or weakness due to spinal cord compression if the spine is involved, and symptoms related to hypercalcemia (high blood calcium) such as nausea, fatigue, confusion, muscle weakness, and kidney or heart problems.
Treatment for bone metastases from breast cancer focuses on relieving symptoms and improving quality of life. This may involve medications to prevent bone breakdown (bone-strengthening drugs such as bisphosphonates or denosumab), pain management using analgesics or radiation therapy targeted to bone lesions, surgery or procedures to stabilize weakened bones or relieve spinal cord compression, systemic therapy addressing the original breast cancer, and minimally invasive procedures like cement injection to strengthen bones and reduce pain.
A multidisciplinary team involving oncologists, orthopedic surgeons, radiation oncologists, pain specialists, and physical therapists typically coordinates care for bone metastases to address both cancer control and symptom management. Early treatment of spinal cord compression is critical to prevent paralysis.
If MBC spreads to the bones in the spine, a person can experience pressure on their spinal cord, causing symptoms such as severe back pain, difficulty walking, and changes to back pain when lying down, standing, or lifting something. In such cases, treatment options may include radiation therapy together with steroids or corticosteroids, or surgery followed by radiation therapy.
Pain medications in the form of pills, patches, or pumps may also be helpful. Safety equipment such as walkers, shower chairs, and handrails may help prevent falls and fractures.
While MBC is currently incurable, a range of treatments can help manage the condition for a number of years, and many people can live long lives with MBC. If a bone is already broken, a surgeon may insert a steel support. In the case of broken bones in the spine, they may inject bone cement in a procedure called a vertebroplasty.
High levels of calcium in the blood can be treated with intravenous fluids to protect the kidneys. Medications such as bisphosphonate drugs can help lower blood calcium levels by blocking the resorption of the bones.
It's important to remember that MBC, like any cancer, can be emotionally challenging. Worry, sadness, fear, helplessness, and disappointment are common emotions for those living with MBC. However, treatments targeting the primary breast cancer may help shrink cancers of the bones in some cases, and common treatments for people with MBC who are experiencing anxiety and depression include one-on-one or group counseling, cognitive behavioral therapy, antidepressants, antianxiety medications, meditation, or yoga.
In conclusion, while bone metastases from MBC can cause a range of symptoms, treatments are available to manage these symptoms and improve quality of life. Early and comprehensive care, involving a multidisciplinary team, is key to managing this condition effectively.
- Metastatic breast cancer can spread to the bones, leading to symptoms such as bone pain, increased risk of fractures, numbness or weakness, and symptoms related to hypercalcemia.
- Treatment for bone metastases focuses on relieving symptoms, improving quality of life, and addressing both cancer control and symptom management.
- A person with MBC who experiences pressure on their spinal cord due to bone metastases may require radiation therapy, steroids or corticosteroids, or surgery followed by radiation therapy.
- Pain medications, safety equipment, and minimally invasive procedures like cement injection can also help manage symptoms and prevent complications like falls and fractures.
- MBC can be emotionally challenging, and common emotions for those living with MBC include worry, sadness, fear, helplessness, and disappointment.
- Treatments targeting the primary breast cancer, along with one-on-one or group counseling, cognitive behavioral therapy, antidepressants, antianxiety medications, meditation, or yoga, can help manage anxiety and depression associated with MBC.
