Metástases Ósseas

Bone Metastases

Bone metastases appear as one of the most common complications in cancer patients, representing an important medical issue. This is in part due to bone’s ability to act as a filter for circulating tumor cells. Like the lung and liver, skeletal tissue has the potential to harbor metastatic cells, especially due to its slower sinusoidal circulation.

With the advancement of cancer diagnosis and treatment methods, we have seen an increase in patient survival. However, this also means that more individuals end up developing bone metastases, with tumors such as breast, prostate, lung, kidney and thyroid being the main responsible for these spreads to the skeleton.

The clinical manifestations of bone metastases often involve pain and, in some cases, can lead to pathological fractures, significantly compromising the patient’s quality of life. In these situations, orthopedic surgical intervention becomes essential to alleviate pain, restore function and avoid serious complications.

The most common sites for these injuries include the femur, humerus, vertebrae, pelvis, scapula, and tibia. The therapeutic approach generally involves resection and reconstruction surgeries, using techniques such as osteosynthesis with cement or endoprosthetic implants. In some cases, radiotherapy may be used as a palliative measure to relieve pain in patients who are not candidates for surgery.

In the context of multiple myeloma, one of the most common primary bone tumors, treatment usually involves chemotherapy and, in certain cases, radiotherapy. However, when bone lesions become significant or present a risk of fracture, the orthopedic surgical approach follows the same principles adopted for bone metastases from other types of cancer.

In summary, the management of bone metastases requires a multidisciplinary approach, involving oncologists, orthopedic surgeons and radiation oncologists, with the aim of providing pain relief, preserving function and improving the quality of life of patients affected by this complication of cancer.

Author: Prof. Dr. Pedro Péricles Ribeiro Baptista

 Orthopedic Oncosurgery at the Dr. Arnaldo Vieira de Carvalho Cancer Institute

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