Methods for examining bone metastasis of colon cancer

In recent years, with the continuous improvement of people's living standards, changes in eating habits and dietary structure, and the aging of the population, the incidence and mortality of colorectal cancer in my country have maintained an upward trend, and most patients are already in the middle and late stages when they are discovered. Colorectal cancer generally metastasizes to the liver, lungs, and abdominal cavity, while bone metastasis is relatively rare.

The first bone metastasis of colorectal cancer is rare clinically. There are generally no symptoms in the early stages, and bone isotope scanning can reveal diseased bones. The symptoms of colorectal cancer bone metastasis are related to the site and number of tumor metastases. For example, chest pain caused by rib metastasis is often manifested as pain localized in the chest wall with clear tenderness points. Spinal cord metastasis causes pain in the middle of the back or the lesion site, while bone metastasis of the limbs or trunk causes localized pain in that area. At first, the bone pain is not obvious and it is not easy for patients to find it. However, as the disease gradually worsens, the bone pain will worsen and affect the patient's daily actions and life. Late-stage bone metastases are mostly osteolytic lesions, so pathological fractures and paralysis sometimes occur.

When colorectal cancer metastasizes to the bones, most patients are already in the late stage, which not only causes physical pain and increases the suffering of the patients, but also the difficulty of treatment at this time can be imagined, and cure has almost become an impossible task. It often takes more than 1 year from the occurrence of bone metastasis to the onset of clinical pain. Therefore, colorectal cancer patients should not refuse clinical examinations and rule out symptoms of colorectal cancer bone metastasis because of the absence of pain symptoms. Cancerous bone pain is characterized by fixed location, gradually increasing pain, and more obvious at night. Early detection of symptoms of colorectal cancer bone metastasis can help improve the cure rate of colorectal cancer bone metastasis.

Although colorectal cancer bone metastasis is relatively serious, as long as the patient has confidence and can actively cooperate with the doctor's treatment, there is a chance of treatment and survival can be prolonged as much as possible. In order to prevent the occurrence of colorectal cancer bone metastasis, patients should receive timely treatment in the early stage, and pay special attention to whether there is a trend of metastasis, and eliminate the impact of metastasis on the patient as soon as possible. There are many imaging examination methods (CT, PET-CT, isotopes, etc.), and fine needle puncture of suspicious lesions is the main means of clear diagnosis.

The treatment of bone metastasis of colorectal cancer is the key, with detailed preoperative evaluation and multidisciplinary discussion. For patients with resectable disease, primary surgery and postoperative adjuvant therapy can be considered. Regular follow-up examinations are required after surgery to effectively control recurrence and metastasis. For patients with unresectable disease, adjuvant therapy can be considered and then evaluated. The emergence of bisphosphonates and targeted drugs has brought new hope to patients and clinicians. When used in combination with radiotherapy and chemotherapy, they can reduce the toxic side effects of radiotherapy and chemotherapy and improve their efficacy. For patients with advanced cancer pain, radiotherapy and palliative chemotherapy are also an effective way to relieve pain.