Bone Mets Are Not the Same as Primary Bone Cancer

The Difference Between Primary Bone Cancer and Bone Mets

Trying to understand how cancers that spread to the bone (bone mets) are different from primary bone cancer can be confusing. Let’s start with the concept of primary cancer.

Primary cancer refers to where a cancerous tumor first begins. If it originates in the breast, it is called primary breast cancer; if it starts in the lung, it is called primary lung cancer, and so on for other organs. If breast cancer metastasizes (spreads) to another organ – let’s say the lung – it is called secondary or metastatic breast cancer to the lung since the primary tumor started in the breast. To verify that it is not primary lung cancer, a needle biopsy is done to remove tumor cells for analysis. Usually, under a microscope the cells will have more features of breast cancer than of lung cancer. However, if certain cell lines are hard to distinguish, special tests are done to isolate cell factors that define one or the other. It is very important to know which cancer is present because different treatments are needed.

To continue the breast cancer example, if the tumor cells spread to the bone and grow there, it is called secondary or metastatic breast cancer to the bone. Thus, the patient now has bone mets. Bone mets are different from the kinds of primary bone cancer that begin in the bone itself or its cartilage lining/pads. Like organ cancers, primary bone cancer can metastasize (often to the lungs) in which case it is called metastatic bone cancer to the lung. Whereas primary bone cancer is rare (0.2% of all cancers), bone mets are much more prevalent. An analysis of insurance claims for the year 2008 calculated at least 280,000 adults living with bone mets. The skeletal areas most frequently affected by organ metastasis are the spine, pelvis and thigh bones.

Once tumor cells start to multiply in the bone and form a new tumor, bone mets are virtually impossible to cure. In addition to severe bone pain, they can cause painful bone fractures due to weakening of the bone; spinal cord or nerve compression; and a condition called hypercalcemia. All of these together can be life threatening, and greatly compromise quality of life. Therefore, treatment is aimed at managing pain, preventing skeletal complications, and preserving quality of life.

Patients with bone mets are in a special situation. Unlike those with primary bone cancer, bone mets patients have also been dealing with their primary cancer for some time. They may already have had one or more surgeries, radiation, and chemotherapy prior to being diagnosed with bone mets, so their therapeutic needs are complex and all-absorbing. The Sperling Medical Group offers a noninvasive ultrasound treatment called ExAblate® MRgFUS to destroy bone lesions and the nerves that relay pain messages. Using MRI to plan and guide treatment with focused ultrasound (sound waves) can bring very quick relief and avoid the need for surgery or radiation. This FDA-cleared treatment has the potential to alleviate suffering and improve quality of life. In one study of 147 patients, reduced pain at the site of treatment was experienced as soon as 3-7 days; by 3 months, 65% reported substantial relief from pain.

If you or a loved one is suffering with painful bone mets, contact the Sperling Medical Group to learn more about ExAblate® MRgFUS and whether it can be helpful in your case.

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¹Li S, Peng Y, Weinhandl ED, Blaes AH et al. Estimated number of prevalent cases of metastatic bone disease in the US adult population. Clin Epidemiol. 2012; 4: 87–93.
²Hurwitz MD, Ghanouni P, Kanaev SV, Iozeffi D et al. Magnetic resonance-guided focused ultrasound for patients with painful bone metastases: phase III trial results. J Natl Cancer Inst. 2014 Apr 23;106(5).