The National Cancer Institute reports the most common locations of cancer metastasis are the lungs, bones, the liver and the brain. Dr. Julia Maltzman of the University of Pennsylvania explains that bone is a rich source of growth factors that create an environment for tumor cells to multiply. The most common metastasis to bone is breast cancer, according to BoneTumor.org, an information website created by Boston orthopedic surgeon Dr. Henry DeGroot III. Half of fractures through a bone lesion are due to breast cancer. Lung, breast. prostate, and kidney cancers also frequently spread to bone.
Chemotherapy
The cancer cells that appear in the bone are the same type as in the primary site. Medications that are used for the primary tumor are used for bone metastases. The National Cancer Institute states that anticancer drugs or chemotherapy are typically given to combat a cancer that is in this state. BoneTumor.org mentions monoclonal antibodies and interferon as additional choices to treat cancer that has spread to the bones.
Bisphosphonates
Dr. Maltzman, writing on the information website OncoLink, recommends that all patients with breast cancer receive bisphosphonates. Fosamax, which is alendronate sodium, etidronate and clodronate are oral bisphosphoanates. Intravenous choices include pamidronate disodium or Aredia and zolendronic acid or Zometa. Bisphosphonates slow down bone resorbtion and have been shown to reduce fractures due to metastasis.
Pain
Bony metastases produce pain, requiring medication. The University of Pennsylvania uses nonsteroidal anti-inflammatories for prostaglandin pain in combination with opioids. Opioid medications include codeines, hyrocodone, morphine, and fentanyl.
Hormone Therapy
BoneTumor.org notes that treatment of a bone metastasis due to prostrate cancer may include medication to suppress male hormones. Options include pituitary suppressing mediation and anti-androgens. Some patients undergo surgical removal of testes, or an orchiectomy, and the use of estrogen.
Blood Vessels
Kidney cancers are very vascular. MayoClinic.com describes the use of medications that block signals for blood vessel growth: bevacizumab or Avastin, pazopanib called Votrient, sorafenib which is Nexavar and sunitinib or Sutent. Treatment may also involve a radiologist blocking blood vessels to the metastasis.
Thalidomide
Thalidomide is used as a leprosy drug. In the 1960s, it caused birth defects when used for morning sickness in expectant mothers. MayoClinic.com reports that thalidomide is approved to be used with the steroid dexamethasone for multiple myeloma, which is a plasma cell cancer affecting bone. Thalidomide is believed to prevent tumor cells from attaching to bone marrow cells. It is being investigated for other cancers.
