Bone pain and cancer
Bone pain is a distressing symptom that can arise from various conditions, including cancer. It often results from tumors either within bones or those that have metastasized from other locations in the body, such as advanced breast or prostate cancer. Individuals with bone diseases, including bone cancers, are particularly susceptible to experiencing this type of pain. Symptoms associated with bone pain may include limited mobility, swelling, fatigue, and even changes in height due to vertebral compression.
Diagnosis typically involves imaging techniques like X-rays, PET scans, CT scans, and MRI, with biopsies used to confirm cancer spread to the bone. Management strategies for bone pain may include medications, such as NSAIDs or opioids, as well as non-pharmaceutical therapies like physical therapy, acupuncture, or massage. Treatments like chemotherapy and radiation can also help alleviate pain by reducing tumor size. The prognosis largely depends on the underlying cause and the effectiveness of treatment, highlighting the importance of addressing both pain management and cancer care to improve quality of life for affected individuals.
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Subject Terms
Bone pain and cancer
Also known as: Skeletal pain
Related conditions: Bone metastasis, fracture
Definition: Bone pain is an uncomfortable response to disease, infection, inflammation, or trauma to bone.
Risk factors: Those at greatest risk for bone pain not caused by fracture or other trauma are those with bone disease, including bone cancers.
Etiology and the disease process: Bone pain in cancer may be caused by tumors in or near bones or conditions that cause damage within the bone, such as multiple myeloma. Cancer that spreads, or metastasizes, to bone from another part of the body can result in bone pain. Medications given to stimulate the production of blood cells in the bone marrow may cause temporary bone pain.
Incidence: Bone pain is experienced in more than half the cases of bone metastasis. There is a higher incidence in patients with advanced disease, particularly in those with breast and prostate cancers.
Symptoms: Symptoms include limited mobility, swelling in the area of pain, fatigue, and lack of appetite. Loss of height is associated with bone compression in the vertebrae. Burning or tingling sensations may indicate nerve involvement. Fracture, a late sign of advanced disease, is another source of pain.
Screening and diagnosis: Bone lesions are detected on x-rays, positron emission tomography (PET) and computed tomography (CT) scans, and magnetic resonance imaging (MRI). A biopsy is necessary to determine if cancer has spread to the bone. The level of pain is assessed using a variety of scales. A commonly used scale uses a zero to ten rating, where zero correlates with no pain and ten with the worst possible pain. Other evaluations are employed to describe the type and quality of pain.
Treatment and therapy:Chemotherapy and radiation alleviate or diminish pain by reducing tumor size. Bone pain is managed with medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, muscle relaxants, opioids, antidepressants, and antianxiety drugs. Nonpharmaceutical interventions used alone or in conjunction with medication can be effective. Examples include physical therapy, exercise, acupuncture, aromatherapy, biofeedback, breathing exercises, hypnosis, massage, and nerve stimulation. Surgery may be necessary to stabilize weakened bones with rods or special cements.
Prognosis, prevention, and outcomes: Prognosis depends on the ability to treat the underlying cause of the pain. An increase in bone pain may indicate disease progression that can lead to serious injury, including fracture, loss of bladder and bowel control, and paralysis. Chronic bone pain can be effectively managed to maximize functionality and quality of life in cases in which it cannot be completely eradicated.
Bibliography
Davies, Andrew. Cancer-Related Bone Pain. New York: Oxford UP, 2007. Print.
Falk, Sarah, Maria Uldall, and Anne-Marie Heegaard. "The Role of Purinergic Receptors in Cancer-Induced Bone Pain." Journal of Osteoporosis (2012): 1–12. Print.
Heymann, Dominique. Bone Cancer: Progression and Therapeutic Approachs. Boston: Elsevier/Academic, 2010. Print.
Morita, Katsuya, et al. "Palliation of Bone Cancer Pain by Antagonists of Platelet-Activating Factor Receptors." PLoS ONE 9.3 (2014): 1–10. Print.
Wu, Jianguo, et al. "The Potential Therapeutic Targets to Bone Pain Induced by Cancer Metastasis." Journal of Cancer Research and Therapeutics 9.S3 (2013): S133–39. Print.