Can bone metastases be cured?

In general, bone metastases are currently difficult to cure, but systemic interventions can slow disease progression, alleviate bone pain, and prolong survival. Common treatment approaches include radiotherapy, medication, surgery, analgesia, and targeted therapy. A detailed analysis is as follows:

1. Radiotherapy

External beam radiation achieves pain relief in over 80% of solitary lesions and reduces the risk of fractures. For critical areas such as the spine, stereotactic techniques can deliver high-dose radiation while protecting the spinal cord.

2. Pharmacological Therapy

Bisphosphonates or denosumab inhibit osteoclast activity and reduce bone destruction. Chemotherapy regimens should be selected based on the pathology of the primary tumor and its sensitivity. Endocrine therapy is suitable for hormone-dependent cancers such as breast and prostate cancer.

3. Surgical Treatment

Surgery is indicated for structural instability or nerve compression. Vertebroplasty, involving injection of bone cement, provides immediate spinal stabilization. Pathological fractures in long bones can be managed with intramedullary nailing. Preoperative assessment of overall health and life expectancy is essential. Postoperatively, radiotherapy is often combined to reduce recurrence risk.

4. Pain Management

Mild to moderate pain is treated with nonsteroidal anti-inflammatory drugs (NSAIDs), while moderate to severe pain requires opioid-based sustained-release formulations. For refractory pain, options such as nerve blocks or intrathecal pumps may be considered. Side effects like constipation and nausea should be proactively prevented.

5. Targeted Therapy

This depends on molecular testing. For lung cancer with EGFR mutations, osimertinib may be used; tumors with high PD-L1 expression may respond to immune checkpoint inhibitors. Regular imaging assessments and toxicity monitoring are necessary during treatment.

It is recommended to consume adequate amounts of high-quality protein daily to maintain muscle mass; engage in water-based exercises or rehabilitation training to improve mobility; regularly monitor blood calcium levels; repeat bone scans promptly if bone pain worsens; ensure home safety to prevent slips and falls; and actively communicate with physicians to adjust pain management plans if pain control is inadequate.