Diagnosis and treatment of metastatic bone cancer

Metastatic bone cancer refers to malignant tumors that originate from extra-bone organs or tissues, metastasize to bones through the blood or lymph nodes, and continue to grow to form daughter tumors. The most common age is 40 to 60 years old, and it is rare in children. Most of them originate from neuroblastomas; the most common site is the trunk bones. Tumors that often metastasize to bones include breast cancer, prostate cancer, lung cancer, kidney cancer, etc.

The most common clinical manifestation of metastatic bone cancer is pain, followed by pathological fractures and spinal cord compression symptoms.

The X-ray manifestations of metastatic bone cancer are osteolytic, osteoblastic and mixed bone destruction, with osteolytic destruction being the most common. Laboratory examinations show that most patients have elevated blood calcium, and some patients have elevated serum alkaline phosphatase and acid phosphatase.

A positive attitude should be taken towards the treatment of metastatic bone cancer, with the goal of prolonging life, relieving symptoms and improving quality of life. Treatment should be targeted at primary cancer and metastatic lesions, using chemotherapy, radiotherapy and endocrine therapy, such as orchiectomy, adrenal cortex resection, hypophysectomy, etc. Surgical treatment is mainly palliative. For metastatic cancer of the spine, fixation surgery can be performed to prevent paraplegia; pelvic tumors can perform local resection, internal fixation or artificial hip replacement. In order to reduce the patient's pain, the three-step ladder therapy recommended by the World Health Organization can be used for analgesia. For unbearable severe pain, palliative amputation can be performed.