This week, I'd like to discuss a complication that can occur with advanced cancer that many of you may be unaware of. Bone metastasis occurs when cancer cells spread from their original site to a location in the bone. The most common types of cancer more likely to spread to bone include breast, prostate and lung cancers.

Bone metastasis can occur in any bone, but more commonly occurs in the pelvis and spine. Bone metastasis may be the first sign that you have cancer, or it may occur years after your cancer treatment is completed.

Signs and symptoms of bone metastasis may include the following:

• Bone pain (back and pelvic pain are most common)
• Unexplained broken bones
• Loss of urine and/or bowel function
• Weakness in the legs
• High levels of calcium in the blood (hypercalcemia), which can cause nausea, vomiting and confusion

The most common problem with metastatic bone cancer is pain and fractures. Metastatic bone cancer usually can't be cured, but instead the goal is to provide pain relief and control further spread. Treatment can make a big difference and may include the following:

• Medications to repair and build new bone — These medications are similar to those used by people with osteoporosis and can help in building and strengthening your bone.
• Chemotherapy — Given as a pill or through a vein, used to control and treat cancer that has spread to the bone.
• Traditional radiation therapy — Radiation is given as external beam therapy to treat the cancer in the bone.
• Hormone therapy — Medications are used to block hormones (for breast and prostate cancers) that help control the spread of cancer to the bone.
• Surgery — Used to fix a fracture and stabilize a break from the cancer in the bone.
• Cryoablation — A special technique that freezes the cancer cells.
• Radiofrequency ablation — A special technique that heats the cancer cells.
• Chemoradiation — A form of internal radiation that is given through the vein and travels to the site of bone metastasis and targets the cancer cells.
• Pain medications — Medications provided with the goal of relieving and controlling pain from bone metastasis.
• Physical therapy — Exercises may be prescribed to assist in strengthening muscles and providing any assistive devices that may help you (cane, walker, crutches, etc.).

If you're living with metastatic bone cancer, you may find help and resources from a website called Bone Health in Focus. It was established with partners including BreastCancer.org, the National Lung Cancer Partnership and Us TOO International Prostate Cancer Education & Support Network to offer resources that help patients and caregivers understand more about cancer that has spread to the bone (find the site at www.bonehealthinfocus.com).