If the bone metastases become apparent because of a fracture, the management issues are complicated. Surgery may be required to repair the bone and should be done if it is a weight-bearing bone. Fractured ribs, on the other hand, are not treated with a cast or immobilization. All such fractures should be treated with radiation therapy as well.
Bone metastases to the spine are a particular concern because a fractured vertebra can result in the loss of function of the limbs or bowel and bladder. Tumors in these bones, therefore, may need to be treated even though they are not weight-bearing bones and even when there are no symptoms.
Liver Metastases
Treatment of liver metastases depends on the organ where the cancer originated.
Standard Treatment For most metastatic tumors to the liver, systemic chemotherapy directed at the tumor type should be offered. But metastases from some cancers may be approached in a different way.
Occasionally, metastases to the liver are localized in one part of the liver or exist as solitary masses. Such tumors may be surgically removed with a possibility of achieving a cure, particularly with metastases from colon and kidney cancers or sarcoma. Generally, no more than four tumors should be removed from the liver, however. Removing more than four metastases rarely results in a cure and exposes the patient to significant surgical risks.
