Can bone Mets cause bone problems even after they get in remission?

[u/AneurysmClipper]

My buddy has a patient who is done with chemo in remission, but says they are in constant pain in the hip there bone Mets where. It was pretty big he told me I didn't see any patient identifying information ofc he just told me what i just told y'all lol.

[u/zappydoc]

If the tumour has damaged enough bone then there can be insufficiency pain. There may also be nerve damage.

[u/Fabulous_James → u/zappydoc]

How would a tumour cause insufficiency pain?

[u/LR-over-NS → u/Fabulous_James]

Tumor eats up enough femur > even if it scleroses down there’s less healthy bone to weight bear > stress change > insufficiency Fx

[u/AneurysmClipper → u/LR-over-NS]

Thank you doc. Just curious what the treatment would be PT?

[u/LR-over-NS → u/AneurysmClipper]

I’m not an ortho onc so idk, either conservative or prophylactic fixation if there truly is an impending Fx (but they have to be pretty big or eat enough of the weight bearing cortex to do that ). I’m sure there’s articles on there on the management of pain after bone Mets

[u/AneurysmClipper → u/LR-over-NS]

Thank you. when I get off In a few hours ima do my research

[u/QuietRedditorATX]

It makes sense to me.

Your body doesn't just magically fill in with new healthy bone. A lot of damage and distortion was done. And then more damage was done when the drugs/radiation killed everything off.

We get a fever and feel sick from a fee neutrophils during an infection. Your friend just had a swarm of inflammatory cells trying to clean up all of this dead tissue and debris.

[u/AneurysmClipper → u/QuietRedditorATX]

Thank you !

[u/AutoModerator]

Thank you for contributing to the sub! If your post was filtered by the automod, please read the rules. Your post will be reviewed but will not be approved if it violates the rules of the sub. The most common reasons for removal are - medical students or premeds asking what a specialty is like, which specialty they should go into, which program is good or about their chances of matching, mentioning midlevels without using the midlevel flair, matched medical students asking questions instead of using the stickied thread in the sub for post-match questions, posting identifying information for targeted harassment. Please do not message the moderators if your post falls into one of these categories. Otherwise, your post will be reviewed in 24 hours and approved if it doesn't violate the rules. Thanks!

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/JROXZ]

Also. You can have rampant fibrosis and remodeling causing the bone to expand/warp = pain.

[u/bushgoliath]

Anecdotally, a ton of my patients report this. I honestly don't know the biology behind it. But there's something about the remodeling that happens when patients lay down new bone that results in a lot of chronic discomfort. Never heard about excruciating pain outside of an underlying pathologic fracture, but very common to hear patients tell me that they "still feel the tumor" or that it's just a low level, constant pressure feeling.