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Bone Metastasis: Local Treatments

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The bones are the most common place where metastatic breast cancer cells tend to travel. How do treatments work for breast cancer in the bones? First, it helps to understand how breast cancer cells behave in the bones.

A bone can function like a “reservoir” that traps and holds breast cancer cells. For some time, those cells might not cause any problems. Eventually, though, the cancer cells can hijack the normal, healthy process through which bone tissue regenerates itself.

Your bones are constantly breaking down and clearing away old cells and stimulating new cells to grow. Breast cancer cells in the bone can speed up the breakdown of normal bone tissue and weaken the bones; this is called osteolytic metastasis. Breast cancer cells also can overstimulate the production of new bone, leading to large, rigid growths. This is called osteoblastic metastasis.

It’s possible to have osteolytic metastasis, osteoblastic metastasis, or a mix of both. Treatment helps slow or stop these bone metastasis cycles to reduce the risk of what's called a skeletal-related event, or SRE.

Examples of SREs include:

  • bone fracture
  • spinal cord compression: a bone fracture that presses on the spinal cord
  • the need for surgery or radiation therapy to the bone
  • hypercalcemia of malignancy, or an excessive amount of calcium in the blood

It’s important to address any potential symptoms of bone metastases quickly. The goals of treatment are to relieve pain, preserve function, and prevent SREs.

There are many treatment options for bone metastasis. Your doctor may recommend just one or a combination of approaches depending on your symptoms, how extensive the cancer in the bone is, and whether it has progressed enough to create a fracture risk.

As needed, your doctor will call in other specialists, such as a radiation oncologist and/or surgeon, to deliver treatments. Your doctor can advise you on which treatments make the most sense for your situation. Your choices may depend in part on what technologies (and expertise) are available close to where you live.

Local treatments can include:

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