In the advanced stages of cancer, tumor cells may spread from the affected organ to different parts of the body, including the brain, liver, bones, etc. This process is called metastasis, and it occurs when cancer cells are released to the bloodstream, allowing them to freely invade other organs. The most common site of bone metastasis is the spine. Other sites include the hip, the upper leg, the upper arm, the ribs, and skull. Once cancer spreads to the bones, cure can be difficult. With bone metastases, life expectancy can be shortened, but there are ways of helping a patient feel more comfortable and improve the quality of life.

What's the Life Expectancy of Bone Metastasis?

The prognosis (outcome) of cancer that has spread to the bones varies according to many factors. With bone metastases, life expectancy depends on the type of primary cancer, your response to treatment, bones affected, severity of bone damage, etc. Various treatments for bone metastases can help relieve symptoms and prolong life.

However, it should be noted that when cancer has invaded the bones, the chances for living more than 5 years are generally poor. Patients may be able to survive 6 months to 2 years with proper treatments. In general, patients with bone metastases from breast or prostate cancer tend to survive longer than those from lung cancer. In addition, emotional support from family members and friends plays an important role in longer life expectancy.

How to Treat Bone Metastasis

Even with bone metastases, life expectancy can be improved using a number of treatments:

1.    Radiation Therapy

Radiation therapy is commonly used to treat bone metastasis. Radiation may be administered as an external beam or as systemic therapy. External beam therapy is used to treat spinal cord compression and bone pain as well as to prevent or heal bone fractures. In this treatment, radiation beams from a machine are directed to a specific bone area that needs the treatment. A short radiation therapy course such as once a day for 5 days is often needed for bone metastases.

Systemic radiation may be administered for pain affecting many bones, which is common in prostate cancer. This type of therapy uses radioactive drugs that are given through a needle (intravenous). The most common are samarium-153 and strontium-89. 

Side effects may depend on the type of therapy, the specific area of the body being treated and the duration of treatment. You may experience a temporary increase in bone pain before improvement is felt.

2.   Bisphosphonates

These are drugs that help retard the breakdown of affected bones. In patients with bone metastases, life expectancy can be prolonged with this method. They are often used to help reduce problems such as hypercalcemia, fractures and bone pain. Bisphosphonates are often administered intravenously, once a month, once every 3 months, or more often if needed. They may also be taken once a day, orally, as a pill. They can be used in combination with other treatments such as chemotherapy, radiation therapy, and pain medications. Side effects include diarrhea, flu-like symptoms, heartburn and nausea.

3.   Pain Medicines

Medicines are often used to reduce pain related to bone metastases. They are often taken as a pill, such as acetaminophen, ibuprofen and naproxen. Opioids like morphine, hydromorphone and codeine may be used to treat moderate to severe pain. Nerve pain may be treated with gabapentin and pregabalin. Common side effects include upset stomach, constipation and drowsiness.

4.   Chemotherapy

In patients with bone metastases, life expectancy may be longer when using this therapy. Chemotherapy helps reduce bone metastases and relieve pain and other symptoms. It may also be used to in combination with other modes of therapy to kill cancer cells. Side effects depend on the type and dose of drugs used, including low blood cell count due to bone marrow suppression, nausea, vomiting, as well as mouth and bowel problems.

5.   Hormonal Therapy

Hormonal treatment may be used to add, block or remove certain hormones in the body to slow the growth of hormone-dependent cancer cells. This type of treatment may involve the use of drugs, radiation, or surgery to manipulate the hormones. It may help relieve bone pain and has fewer side effects compared to chemotherapy. These include hot flashes and reduced sexual drive.

6.   Surgery

In patients with bone metastases, life expectancy can be prolonged with surgery which is used to repair broken bones. It is used to stabilize weak bones to prevent them from breaking. Metal pins, screws, rods and plates may be used to strengthen affected bones and relieve pain from broken bones. It is also important when there is a risk of spinal cord compression. However, patients with bone metastases have to be in good health to undergo surgery. Side effects may include bleeding, wound infection, and post-operative pain.

7.   Bone Cement

Surgeons may use bone cement to stabilize an affected bone, to relieve bone pain, and to prevent fractures. It may help improve mobility. Bone cement is often used in treating the bones of the pelvis, arms, legs, and spine. Bone cement (polymethyl methacrylate) is injected through the skin. This is done under local anesthesia and uses fluoroscopy to guide the needle to the right part of the bone. Side effects include pain and possible infection.