Bone metastases
The most frequent site of bone metastases are vertebral metastases, likely related to the high hematopoietic activity and vascularization of the spine 1).
The spine is the commonest site for bone metastases, and the incidence of spinal metastases is increasing 2).
Approximately two-thirds of cancer patients will develop bone metastases and it is estimated that over 10% of patients with cancer will develop symptomatic spinal metastases.
More than 50% of patients with spinal metastases have multiple levels involved.
see Skull metastases
Cancer cells that break off from a primary tumor and enter the bloodstream or lymph vessels can reach nearly all tissues of the body. Bones are a common place for these cancer cells to settle and start growing. Tumors that result from these cells entering the bones are called bone metastases.
Presence of bone metastases at baseline was associated with a worse prognosis for patients with Non-Small Cell Lung Cancer treated with Immune Checkpoint Inhibitor after controlling for multiple clinical characteristics. Use of bone-modifying agents (BMAs) was not associated with reduced skeletal-related events (SREs) or a difference in survival 3).
Diagnosis
see 18F positron emission tomography for bone metastases.
Treatment
For pain Steroids, aspirin, or NSAIDs are especially helpful, probably by reducing prostaglandin mediated sensitization of A-delta and C fibers, and therefore may be preferred to acetaminophen.
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