Ask an Expert: Treating Cancer That Spreads to Bones

Cancer that has spread to the bone is called metastatic bone disease. Many people who have cancer will develop bone metastases, which can cause pain, fractures or spinal compression and affect mobility and quality of life. To address this challenge, the Froedtert & the Medical College of Wisconsin Cancer Network created the Bone Metastasis Program — a team of doctors and clinicians who specialize in treating people with metastatic bone disease. 

Meena Bedi, MD, radiation oncologist, answers questions related to metastatic bone disease and why the Bone Metastasis Program is an important resource for patients whose cancer has spread to the bone. 

Which cancers most commonly spread to the bone? 

All cancers can spread to the bone, but of these, the most common are breast, lung and prostate cancers. They are also three of the most prevalent cancers we treat. 

What symptoms might indicate metastatic bone disease? 

People often have pain. Sometimes, they can’t bear weight or have difficulty walking. Occasionally, they fall. Patients may also have no symptoms or discomfort. In those cases, the disease is often revealed during routine imaging. 

Why is the Bone Metastasis Program an important resource? 

Bone metastasis is seen more often because people are living longer with cancer — beyond their initial primary diagnosis. They are more likely to survive long enough that their disease will spread to other areas of their bodies, especially their bones. Treating bone metastasis requires dedicated expertise from many disciplines. 

Are most of your patients older? 

Most cancer patients are older, but we also treat people in their 30s, 40s and early 50s. With breast cancer, we are seeing women who are premenopausal. Also, more people are developing colon cancer in their 30s and 40s, which can be metastatic at the time of diagnosis. 

Is it difficult to treat metastatic bone disease? 

It is nuanced. No two patients are alike. Even if they have the same kind of cancer in the same area, our recommendations for one person may be different from recommendations for another. Sometimes, we have to consider how we will fold treatment into chemotherapy a patient is already receiving. We work with the medical oncologist to create a personalized plan. 

It sounds like teamwork is key. 

Our multidisciplinary approach is essential. We work together to determine the optimal treatment for each individual. Efficient, effective collaboration really is key because it gives our patients the best chance of an improved outcome. That is important to us. 

What are some of the bone metastasis treatment strategies? 

When a patient has a fracture or is likely to have one, we often perform surgery to remove the tumor and stabilize the extremity with hardware. Often, surgery is followed by radiation therapy. Another approach is interventional radiology, using techniques such as ablation, which destroys the tumor with heat, or cryotherapy, which freezes the tumor to destroy cancer cells. While the Bone Metastasis Program is new, we plan to offer clinical trials specific to this patient population.