Bone Metastasis Can Alter Quality of Life

A substantial amount of published research on cancer that metastasizes (spreads) to the bones (bone mets). Most of it is focused on theories of how and why cancer cells seem especially drawn to bone, and also the physical processes involved in tumor growth and bone damage once cancer settles there. Another portion of research is devoted to the physical problems patients experience (e.g. pain, fractures, etc.) and how to treat them.

Quality of life

The smallest proportion of clinical literature on bone mets deals with how patient quality of life is affected. One author makes a very important point: “Metastatic bone disease can have serious physical, psychological and social implications for patients and their carers.”ⁱ The quality of life experienced by patients and those who love them may be lessened by bleaker attitudes, communication challenges, diminished energy, restricted mobility, and loss of work/income, to name just a few.

Increasingly, medical professionals who work with bone mets patients – doctors, nurses, PA’s, physical therapists, social workers – are recognizing that the emotional, mental, relationship and financial offshoots of bone mets must be addresses as much as the physical effects. Here are some of the ways in which bone mets impacts quality of life:

a) Emotional needs can become more intense. Feelings of sadness, depression, anger, disappointment, fear, and anxiety may be difficult to express to loved ones and professionals. The act of “corking them up” adds to silent inner suffering, or “explosions” of negativity toward loved ones and caregivers. It is important to be able to identify and vent feelings with safe, trusted people in order to alleviate the internal build-up of emotional pressure.

b) Mental needs have to do with thoughts, ideas, beliefs, and worldview. Even the sunniest, most optimistic patients have a hard time intellectually, since there is no logical explanation why this is happening to them. It’s not possible to simply talk oneself out of pain or new daily challenges that create stress. On the other hand, factual information and education can often help a patient cope, since “knowledge is power” and can help instill confidence in strategies and solutions suggested by the care team.

c) Relationship stressors can quickly build up, especially when there isn’t time or emotional energy to sit down and talk things through. Growing social isolation or distance between intimate partners can lead to resentments, misunderstandings, and destructive false assumptions. These make it harder for the patient to receive care, and more difficult for the caretaker to experience satisfaction in giving it. In many instances, members of the medical team, especially social workers, can help partners and family members restore a sense of closeness and constructive mutual problem-solving.

d) Financial stress is sure to build up if patients and their families are faced with daunting medical expenses. Treating metastatic cancer is a big-ticket item in itself. Add to medical bills the costs of additional child care and home help, not to mention lost work time resulting in lower income, and you have the makings of true economic hardship.

Experts agree that bone mets patients and their caretakers are well advised to be open and honest with their medical team about the ways in which their disease is beginning to drag down their quality of life. Many times, there are community resources that can ease daily tasks, boost attitudes and feelings, add enjoyment, and help restore many other aspects of lifestyle quality. By identifying bone mets-related stressors at the earliest sign, it is possible to generate renewed energy and hope.

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ⁱ O’Leary, U. Bone metastasis: secondary illness, primary concern. Nursing Times. 97 (41):32. https://www.nursingtimes.net/clinical-archive/cancer/bone-metastasis-secondary-illness-primary-concern/200579.article