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Bone Complications in Lung Cancer

Summary & Participants

When lung cancer spreads to the bone it can cause severe pain and weak bones. Learn how these bone complications can be treated and even prevented, making life a little easier for the person with lung cancer.

Medically Reviewed On: July 01, 2008

Webcast Transcript

ANNOUNCER: Lung cancer, one of the most common cancers in the U.S., can sometimes spread into other areas of the body, particularly the bone. Today there are new drug treatments available for patients with this added complication.

ROGER WALTZMAN, MD: Skeletal complications arise in any cancer really from hemtogenous spread of disease, which means cells breaking off from a primary tumor site and traveling through the blood stream, which enables them really to travel anywhere. For reasons that are really not clear to the cancer community, the bone is a very common site for cancers to spread.

ROBERT FIGLIN, MD: Lung cancer spreads to the bone in a minority of patients with lung cancer, but when it does so, it can be a major complication of that disease.

ROGER WALTZMAN, MD: If the disease has spread to the bone, then the goal of therapy is palliative care to minimize the complications of the disease and minimize the side effects of both the disease and the therapy.

ANNOUNCER: Pain is usually the first sign that cancer has spread into the bones.

ROGER WALTZMAN, MD: The pain is usually described as a persistent nagging, gnawing moderate or severe discomfort in one particular site of the body

The most important therapy that is almost always used for treatment of pain related to lung cancer metastatic to the bone, is opioid analgesia. Those are the pain medications like morphine and its derivatives.

ROBERT FIGLIN, MD: If you're a patient with a complication of bony metastases, you want to have five points that you ask your doctor. What's the appropriate time for prevention? What's the appropriate time for treatment with pain? What's the appropriate role of radiation therapy? What's the appropriate role of surgery? And what's the appropriate role of chemotherapy or systemic treatment?

ANNOUNCER: One of the systemic treatments available are is a class of drugs called bisphosphonates.

ROGER WALTZMAN, MD: These are drugs that are available primarily intravenously, but also orally and that are commercially available and approved, indicated for metastatic lung cancer to the bone.

ROBERT FIGLIN, MD: The bisphosphonates are potent agents that destroy and ameliorate what is called the osteoclast, which is one of the cells in bones that can destroy bone and create problems, and by destroying that osteoclast, you basically destroy the ability of the cancer to effectively reduce the strength of the bone.

ROGER WALTZMAN, MD: The ones that we most commonly use are called Aredia and Zometa. And these drugs are given intravenously, one for a couple of hours, one for just 15 minutes on about every three or four week basis. And have been demonstrated not to cure the disease to the bone, but to decrease the pain associated with it and to decrease the likelihood of their being further events of new bone disease or fractures from the pre-existing bone disease.

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