Questions to Ask About Bone Metastases

General Questions to Ask Your Physician and Potential Answers

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What causes bone metastases?

Bone metastases aren’t the same as bone cancer. Bone metastases are formed from cancerous cells that start elsewhere in your body. So, bone metastases could, for instance, be cancerous breast tissue, or another type of tissue somewhere in your body, that has started growing inside the bone tissue.

1http://www.healthline.com/health/bone-metastases#Overview1

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Why do cancers metastasize to bones?

For cancer cells to spread to other parts of the body, they have to go through many changes:

They have to be able to break away from the original (primary) tumor and get into the bloodstream or lymph system, which can carry them to another part of the body.

At some point they need to attach to the wall of a blood or lymph vessel and move through it, out into a new organ.

They will then grow in their new location. All the while, the cancer cells need to be able to avoid attacks from the body’s immune system. Going through all these steps means the cells that start new tumors may no longer be exactly the same as the ones in the tumor where they started, but they will still be called the same name. For instance, breast cancer that spreads to the bone is called metastatic breast cancer, not bone cancer.

2https://www.cancer.org/treatment/understanding-your-diagnosis/advanced-cancer/what-is.html

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How are bone metastases diagnosed?

Your doctor will perform a full medical history and physical exam, including a discussion of any past incidence of cancer. They can then order several tests, including:

X-rays of the affected bone

bone scans to see if other bones are affected

CT scans

MRI scans

blood tests

If your doctor needs to determine whether the affected bone is the result of a bone metastasis or a primary bone cancer, they may perform a biopsy. During a biopsy, they’ll remove a small amount of the tumor and send it to a pathologist for a thorough examination.

3http://www.healthline.com/health/bone-metastases#Overview1

Possible Questions to Ask About Your Case

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How many tumors do I have?

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What are their sizes?

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Where are they located?

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Is there a risk of fracture from my bone metastases?

Questions You Can Ask About Your Treatment Options

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Where are they located?

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What should I expect for each treatment I am considering (visits, duration, anesthesia, pain, recovery time, etc)?

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How soon will I feel improvement in pain after each treatment I am considering?

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Can I continue to receive chemotherapy treatment?

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What are the side effects of each procedure I am considering?

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What are the advantages and disadvantages/risks of each of the treatment options?

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Does it affect my ability to receive additional treatments later on?

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Can it be done following radiation to the same area?

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How do I know if I am eligible for treatment?

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Are these options routinely covered by insurance?

Questions Your Doctor May Ask You

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Are you currently undergoing chemotherapy treatment?

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Have the met/s been treated with radiation?

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Are you able to undergo general anesthesia?

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Do you have any metal implants? Are they MR-compatible?