Bone Metastases

Mechanism of disease for the development of bone metastases in advanced cancer

Cancer cells shed from the primary tumor and enter the blood and lymph circulation, releasing growth factors, cytokines, and other proteins which promote bone adhesion and abnormal proliferation.1 Circulating cancer cells initially adhere to cells lining blood vessels in bone marrow.2 Tumor cells are actively recruited to the bone microenvironment by multiple factors and preferentially adhere to areas of increased bone turnover.1‑6

Tumor cells that have invaded bone secrete multiple factors that stimulate osteoblasts to overproduce a key signaling molecule.7 Increased levels of this signaling molecule drive excessive osteoclast activity and bone resorption resulting in destruction of the bone matrix.7 Increased bone resorption releases growth factors from the bone matrix, which may further stimulate tumor growth and bone destruction leading to the further development of bone metastases.8‑14

Bone metastases are different from bone cancers. Bone cancers start in the bone. They are less common than bone metastases.15

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