The Importance of Bone Health in Advanced Cancer

As patients and caregivers may know, cancer can spread to other parts of the body, including the bone. Tumors that result from cancer that spreads to the bone are called bone metastases (or bone mets) and they can lead to additional bone complications. Bone complications are especially common in people living with metastatic breast, lung, prostate and other solid tumor cancers, as well as multiple myeloma (a blood cancer that originates in the bone marrow).

Blanca Ledezema is an oncology nurse practitioner who, over the past 15 years, has helped many advanced cancer patients with managing bone complications. This May for Oncology Nursing Month, Blanca explains in a Q&A the importance of bone health in patients with advanced cancer.

What do you believe is your role as an oncology nurse?

A cancer diagnosis can be overwhelming, so my goal as an oncology nurse is to make each patient’s experience at our institution a little better, however I can. Whether that means listening to them for longer periods of time, working with them to try to figure out how to help with issues they’re dealing with, advocating for them in instances where it’s necessary, and, of course, administering prescribed treatments.

Why do you feel bone health is a particularly important topic for patients with advanced cancer?

Bone complications are common in patients with metastatic breast, lung, prostate and other solid tumor cancers, as well as multiple myeloma. If patients and their loved ones are aware of these potential issues, they can better proactively manage them and minimize their impact.

How do bone mets affect the body?

When solid tumor cancer spreads to the bone, the cells that build up and break down bones aren’t working like they should. When the cells that break down bones are overactive, they can break down the bones too much, leading to weakness and associated complications—fractures, chronic pain, limited mobility, and pressure on the spinal cord or nerve damage from spinal bone mets. Sometimes, patients will even need to have radiation treatments or surgery, which we consider complications as well.

What symptoms of bone mets should caregivers watch out for?

Bone mets sometimes happen without the patient experiencing any symptoms. However, even mild pain could be a sign of a fracture, so we encourage patients to report the slightest discomfort. Other symptoms include broken bones, weakness in the legs or arms, and high levels of calcium in the blood.

What treatments are available to help prevent bone complications?

There are prescription treatments available called bone-targeting agents (BTAs). BTAs work by slowing down the overactive cells that are breaking down bones. BTAs are not treatments for the bone mets themselves, but rather they help prevent complications from them. Your loved one’s doctor may also prescribe calcium and Vitamin D supplements to promote general bone health.

What can I do to protect my loved one living with bone mets?

Don’t hesitate to reach out to your healthcare team if your loved one is experiencing symptoms, even if their next appointment isn’t for a while. On the home front, you should be aware of how the layout of your home may create fall hazards. If needed, get devices such as walkers and canes through your healthcare provider. Lastly, you should inform their other providers if they’re on a BTA—especially their dentist, as without a full medical history they may not recognize potential side effects.

How can I find out more about my loved one’s bone health?

If your loved one is at risk, don’t be afraid to ask your doctor about bone mets and complications. Just asking “What is a bone met?” can start an important conversation that could make a difference.

Blanca Ledezema is an oncology nurse practitioner has helped many advanced cancer patients with managing bone complications.