Cancer Related Pain: Metastatic pain

Overview

Patients associate advanced cancer with pain, and for many such patients the source of the pain will be the metastatic bone disease. Bone is one of the most frequent sites of spread for many common cancers such as breast, prostate, lung, and kidney and is usually affected in multiple myeloma. Active management of the metastatic bone disease can, however, control the symptoms and in many cases prevent further complications such as pathological fracture or compression of the spinal cord.

Symptoms

Sometimes, bone metastasis causes no signs and symptoms.

When it does occur, signs and symptoms of bone metastasis include:

• Bone pain
• Broken bones
• Urinary incontinence
• Bowel incontinence
• Weakness in the legs or arms
• High levels of calcium in the blood (hypercalcemia), which can cause nausea, vomiting, constipation and confusion

When to see a doctor

If you experience persistent signs and symptoms that worry you, make an appointment with your doctor.

If you’ve been treated for cancer in the past, tell your doctor about your medical history and that you’re concerned about your signs and symptoms.

Causes

Bone metastasis occurs when cancer cells break away from the original tumor and spread to the bones, where they begin to multiply.

Doctors aren’t sure what causes some cancers to spread. And it’s not clear why some cancers travel to the bones rather than to other common sites for metastasis, such as the liver.

Risk factors

Virtually any type of cancer can spread to the bones, but the cancers most likely to cause bone metastasis include:

• Breast cancer
• Kidney cancer
• Lung cancer
• Lymphoma
• Multiple myeloma
• Prostate cancer
• Thyroid cancer