Bones and Joints - E-book: A Guide for Students
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In contrast, bone metastases are generally painful when they occur. Sometimes, the tumor can completely destroy the bone in a particular area. This type of process is termed osteolytic bone destruction. This type of damage is most common in cancers that have spread to bone from the lung, thyroid, kidney, and colon.
Alternatively, new bone can form in response to the cancer spread.
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This new bone, called osteoblastic, grows abnormally and causes the bone to be weak and deformed. It is more frequently seen in spread of prostate, bladder, and stomach cancer. Breast cancer often behaves in a mixed osteolytic and osteoblastic manner. Osteolytic and osteoblastic metastatic bone disease occurs because the different cancer cells secrete factors that interact with the naturally occurring cells in the bone and cause bone destruction, new bone formation, or both.
Because MBD weakens the affected bones, people with the disease are prone to fractures. Broken bones caused by MBD are termed "pathological fractures. Sometimes the bone has not yet broken but is so weak that a break is imminent. Such scenarios are termed "impending pathologic fractures. This x-ray of the upper arm shows a pathological fracture in the humerus arrow. A cancer patient who experiences any pain, especially in the back, legs, and arms, should notify his or her doctor immediately.
Pain that occurs without activity i.
It is important for your doctor to understand your medical condition and your symptoms. Your doctor will ask questions about the nature of any pain you are having, your current health, and past medical conditions. The information your doctor learns is called your medical history. After the medical history, your doctor will perform a physical examination, concentrating on the painful areas.
After the interview and physical examination, your doctor will order x-rays if he or she suspects that you have metastatic bone disease. Because some pain is referred from other areas for example, knee pain may be arising in the hip , your doctor may order x-rays of bone beyond the areas where you are experiencing discomfort. The x-ray examination can tell an oncologist a great deal of information about whether and how much of the bone is involved.
Other imaging tests. Your doctor may also order a bone scan. This test is helpful in determining if other bones, in addition to the one in question, are involved with metastatic bone disease. A technetium bone scan demonstrates extensive bony metastasis throughout the skeleton arrows. The diagnosis of metastatic bone disease should not be assumed unless a patient has a known primary cancer that has previously spread to bone. In adults older than 45 years of age who have no personal history of cancer and who have a bone growth detected in an x-ray, a specialist consultation should be obtained with an orthopaedic surgeon who has formal advanced training in cancer surgery orthopaedic oncologist.
The orthopaedic oncologist will determine whether this bone tumor is a metastasis from an unknown primary carcinoma or a primary bone cancer sarcoma. For example, if an area of bone has been destroyed, the possible diagnoses include metastatic bone disease or a primary bone cancer, such as myeloma or lymphoma. Cancers that begin in bone are much less common in adults older than 45 years.
Other diseases, such as Paget's sarcoma, post-radiation sarcoma, hyperparathyroidism, and fractures due to osteoporosis, are also possibilities. Additional tests will likely be needed to determine the exact diagnosis. A biopsy may be necessary.
This involves taking a piece of tissue from the tumor and looking at it under a microscope. This may be done in a clinic via a needle biopsy, or as a small surgical procedure.
Bones of the Leg and Foot | Interactive Anatomy Guide
Early identification of metastatic bone disease is very important in order for treatment options to be most effective in maintaining quality of life. Cancer patients should routinely be evaluated with certain blood tests, including a complete blood count, because loss of red blood cells anemia is a frequent finding in metastatic bone disease or multiple myeloma. Blood chemistries i. An analysis of the urine urinalysis can detect blood, which may be present in patients with renal cell carcinoma.
Serum and urine protein electrophoresis are important to exclude multiple myeloma. After the history, physical examination, x-ray and laboratory tests are completed, your doctor will determine whether you have metastatic bone disease. It is important to point out that many cancer patients have bone pain from certain types of chemotherapy, and that just because you have bone or joint pain, it does not mean that you have MBD.
Nevertheless, careful follow up is very important if you are having pain.
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In many cases of metastatic bone disease, the cancer has progressed to the point where multiple bony sites are involved. Skip to main content x Sign In. Sign in to shop, sample, or access your account information. Please review the errors highlighted below before resubmitting. The username and password you entered did not match any accounts in our file. Please try again.
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