Bone metastases for 35 thousand Italians every year: what can be done against pain and fractures

Bone metastases, together with the pain that accompanies them, significantly worsen the life of cancer patients, making it increasingly difficult to carry out normal daily activities, reducing their functional autonomy, exposing them to a high risk of fractures and worsening their psychological and emotional state. If preventing them, to date, is not yet possible, it is however essential to do everything possible to identify them as soon as possible and intervene with the therapies available for slow down its evolution. With the intention of raising awareness among patients and doctors, it was born the survey commissioned by the Italian Oncology Patient Network (ROPI), an anonymous questionnaire to be filled out online which aims to shed light on the complications of bone metastases and on their adequate knowledge by both specialists and those directly involved.

35,000 new cases in Italy every year

Bones are the third most frequent site of metastasis, later lungs and liver. Estimates for Italy report about 35 thousand new cases every year, linked to different types of cancer: more or less 80% of bone metastases arise, however, in people suffering from breast, prostate, lung, kidney, thyroid cancer. And the figures are destined to grow because more and more patients live with a cancer for a long time, even for many years, slowing its progression thanks to new therapies. “About 7 out of 10 women with metastatic breast cancer and over 8 out of 10 men with metastatic prostate cancer also develop bone metastases over time – underlines Stefania Gori, ROPI president who also directs the medical oncology of the IRCCS Sacro Cuore Don Calabria Hospital in Negrar (Verona) -: in one case out of three they are associated with skeletal complications, including pathological fractures. The Engage project (promoted by ROPI with the non-conditioning support of Amgen Italia) aims to prevent complications in as many cases as possible. “Listening” to the bones means for the patient pay attention to the first symptoms that may emerge, such as even minor bone pain. For the oncologist it means paying attention to the bones, actively and routinely searching for the presence of metastases, so as to be able to protect the health of the bones as early as possible even in the absence of pain “. In a quarter of patients, bone metastases are asymptomaticbut in the remaining 75% of cases they lead to a series of complications that are defined as “related skeletal events”, including fractures and spinal cord compressionin addition to pain, which is the most frequent symptom, very disabling for the life of patients, who in the long term are reduced to immobility.

Monitor the situation

It has been widely demonstrated that some anti-cancer therapies can also contribute to these serious health problems: in particular, hormone therapy causes rapid bone loss. On the other hand, it is now possible to resort to the administration of some particular osteoprotective drugs. “A deterioration in the quality of life is linked to bone metastases, as well as an increase in mortality – adds Gori -. Awareness of the risk of skeletal complications it is still quite poor, unfortunately. Few patients are still informed about this type of consequences e it is estimated that only 25% of those with bone metastases today receive bone-specific therapy. It is understandable that the focus is on therapy to fight cancer, but it is necessary to help patients and those close to them to understand that bone care is an integral part of the therapeutic process “. While patients cannot actually do anything to prevent bone metastases, it is very important to live better and longer to live a healthy lifestyle, with a balanced diet and regular physical activity. The best prevention remains early identification of cancer, when the chances of getting better are greater and of not experiencing bone or other metastases. «The regular execution of the control exams is also decisive – concludes Gori -. And when bone metastases are diagnosed, there are treatments that can significantly slow down the onset of skeletal complications ».