Bone metastases

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

see Spinal 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).

see 18F positron emission tomography for bone metastases.

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.


Husband DJ. Malignant spinal cord compression: Prospective study of delays in referral and treatment. BMJ 1998; 317:18-21.

Hatrick NC, Lucas JD, Timothy AR, Smith MA. The surgical treatment of metastatic disease of the spine. Radiother Oncol. 2000 Sep;56(3):335-9. PubMed PMID: 10974383.

Qin A, Zhao S, Miah A, Wei L, Patel S, Johns A, Grogan M, Bertino EM, He K, Shields PG, Kalemkerian GP, Gadgeel SM, Ramnath N, Schneider BJ, Hassan KA, Szerlip N, Chopra Z, Journey S, Waninger J, Spakowicz D, Carbone DP, Presley CJ, Otterson GA, Green MD, Owen DH. Bone Metastases, Skeletal-Related Events, and Survival in Patients With Metastatic Non-Small Cell Lung Cancer Treated With Immune Checkpoint Inhibitors. J Natl Compr Canc Netw. 2021 Apr 20:1-7. doi: 10.6004/jnccn.2020.7668. Epub ahead of print. PMID: 33878726.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.

WhatsApp WhatsApp us
%d bloggers like this: