Bone marrow carcinosis is a rare diffuse metastasis of a cancerous tumor within the bone marrow. It is a complication of bone metastases.
What is bone marrow carcinosis?
Bone metastases or bone marrow carcinosis are usually noticeable through pain in the back or in the limbs, but cannot be clearly assigned as they can also have other causes. See AbbreviationFinder for abbreviations related to Bone Marrow Carcinosis.
Bone marrow carcinosis, also known as bone marrow carcinosis, is the result of bone metastasis. The bone marrow is infiltrated by the small metastases (secondary tumors) of a carcinoma.
Bone marrow carcinosis is considered a complication of bone metastases. They appear in about eight to ten percent of all patients suffering from bone metastases. Bone metastases develop primarily during the progression of cancers such as prostate cancer and breast cancer.
Metastases of the human skeleton can also form as part of thyroid cancer, lung cancer and renal cell carcinoma. In the case of prostate cancer and breast cancer, an average of seven out of ten patients suffer from secondary tumors. Rarely, bone metastases are possible in pancreatic cancer, stomach cancer, liver cancer, black skin cancer, bladder cancer, uterine cancer, ovarian cancer and gallbladder cancer.
Causes
Bone marrow carcinosis is caused by malignant cancerous tumors. Cancer cells, which are able to penetrate the substantia spongiosa (spongy bone or trabeculae) of the bone, are derived from both the tumors and their metastases, allowing them to subsequently invade the bone marrow.
In most cases, this happens with a primary tumor such as breast cancer or bronchial carcinoma. Settlement is accompanied by diffuse infiltration of the hematopoietic (concerning hematopoiesis) system. The invading cancer cells lead to a reduction in the number of blood-forming cells or even no longer being formed at all.
Doctors then speak of terminal myelosuppression. Bone metastases already throw bone formation and breakdown out of balance, but this does not happen immediately. The cancer cells can reach the bone marrow via the bloodstream, where they become established. From there, the daughter tumor then begins to grow.
They emit signals that affect the functions of the osteoclastic and osteoblastic cells. This in turn leads to an uncontrolled build-up and breakdown of bone tissue. The remodeling of the bone leads to the release of growth factors. These stimulate the metastases to grow further. The cancer cells tend to cause indirect damage to the bone.
Symptoms, Ailments & Signs
Bone metastases or bone marrow carcinosis are usually noticeable through pain in the back or in the limbs, but cannot be clearly assigned as they can also have other causes. The characteristic symptoms of bone marrow carcinosis are anemia and reduced blood clotting, which is caused by thrombocytopenia (lack of blood platelets).
Due to a lack of white blood cells (leucocytopenia), there are also disorders of the immune system. As a result, the affected persons are more susceptible to infections. Sometimes there are unexplained fractures.
If the bone metastases also put pressure on nerves in the spinal cord, arm or leg, this leads to sensory disturbances such as numbness and tingling. If the calcium value in the blood increases, this is considered an indication of remodeling processes within the bone. The increase in calcium levels often causes hypercalcemia, which in turn can cause dysfunction in almost any organ system.
In severe cases, hypercalcemia can even be life-threatening. However, it only occurs in about 5 out of 100 patients. The anemia that occurs with bone marrow carcinosis often results in poor oxygen supply to the body. This is usually noticeable through feelings of dizziness, breathing problems and tiredness.
Diagnosis & course of disease
If there is a suspicion of bone metastases or even bone marrow carcinosis, targeted examinations are used. The standard diagnostic method for bone metastases is scintigraphy, in which radioactive substances are injected into the patient’s bloodstream. The markers used are similar to calcium and accumulate in bone regions in which a strong remodeling takes place.
However, there is a risk that a bone scintigram will be negative. For this reason, further investigation methods are necessary. This includes a bone marrow biopsy, during which a puncture is made on the breastbone or on the iliac crest using a hollow needle. The cancer cells can be seen in the smear of the bone marrow. Occasional erythroblasts or immature granulocytes can be found in the peripheral blood.
Furthermore, there is often a slight increase in the number of reticulocytes, which also points to bone marrow carcinosis. The course of bone marrow carcinosis is negative in most cases. Normally, a cure can no longer be achieved because the stage of the cancer is too advanced.
Complications
Bone marrow carcinosis causes cancer in the bone marrow. This is a very serious condition for the health of the patient. In most cases, the patients suffer from severe back pain and also pain in the limbs. If the pain also occurs at night, the patient may have difficulty sleeping and be generally irritable.
Those affected remain susceptible to various infections and suffer from increased fractures. Paralysis and sensory disturbances also develop all over the body, which significantly restricts the patient’s everyday life. Paralysis of the face may also occur, which means that it is usually no longer possible for the affected person to eat and drink.
Breathing difficulties also occur, which can lead to tiredness or dizzy spells. It is not uncommon for patients to lose consciousness. If the treatment is successful, there is no reduction in life expectancy.
When should you go to the doctor?
If you notice an increased susceptibility to infections, broken bones and other signs of a serious illness, a doctor’s visit is necessary in any case. The affected person should quickly go to the family doctor or an internist and have the symptoms clarified. This is especially true if there are other symptoms, such as a feeling of illness or numbness in the arms and legs. Bone marrow carcinosis can cause a wide variety of symptoms, which is why it is often only diagnosed after a specialist examination.
This makes it all the more important to see a doctor early on if you have symptoms, who can make an initial diagnosis and refer the patient to a specialist if necessary. People who have had cancer in the past are among the risk groups. You should definitely discuss the symptoms mentioned with the responsible doctor. If bone marrow carcinosis is actually present, treatment must be initiated immediately. This is usually done by a specialist in internal medicine. An operation in the hospital is usually necessary.
Treatment & Therapy
The occurrence of bone metastases or bone marrow carcinosis is a sign that the cancer has already spread through the body. Therefore, only palliative therapy is possible for most patients. Treatment options include irradiating the affected bone internally or externally. External radiation is referred to by medical professionals as percutaneous radiation therapy.
High-energy rays penetrate the skin from the outside and are intended to kill the tumor cells. Another treatment method is radionuclide therapy, during which the patient is treated with weak radioactive substances. For this purpose he receives an injection.
This procedure allows the radionuclides to be stored directly in the bone and affect the cancer cells, which in turn counteracts inflammation. The procedures described are designed to relieve pain. Bone marrow carcinosis can also be treated with chemotherapy.
Outlook & Forecast
The prognosis of bone marrow carcinosis is extremely unfavorable. Bone marrow disease is a sign that a cancer already present in the organism has already increased in scope and intensity. In general parlance, the cancer is spread in this case. The therapy plan must be changed and adapted to the current findings.
There are only a few therapeutic approaches that lead to an alleviation of the symptoms in the case of a slight infection of the bone marrow. If these are used as quickly as possible and show a corresponding effect within a short time, there is a chance of a later cure. The patient’s organism does not always react as desired to the initiated therapies. A successful course of treatment lasts for several years and is characterized by numerous side effects. The patient is at risk of further secondary diseases and is forced to adapt his entire life to his physical capabilities.
Even with recovery, relapses can occur at any time in the further course or within an ongoing therapy. The more cancer cells invade the bone marrow, the worse the prognosis. For some patients, the focus is on relieving the pain, which is no longer possible to heal. The patient dies prematurely within a few weeks, months or years.
Prevention
Preventive measures against bone marrow carcinosis are not known. She is in a very advanced stage of cancer.
Aftercare
Cancer is one of the diseases for which follow-up care is essential. Quarterly or every six months, the patient presents and takes part in early detection examinations. Doctors expect the greatest treatment success from the discovery of a tumor in the early stages. However, this type of follow-up care is not possible if bone marrow carcinosis has been diagnosed.
The problem goes back to the fact that a cure is almost impossible. The disease is advanced by the time it is diagnosed. Accordingly, a recurrence cannot be prevented; the cancer is permanent. The therapy aims to eliminate complications and enable the patient to live a pain-free life.
Strictly speaking, this part is not part of the follow-up care, as a treatment has not been completed or provisionally ended beforehand. The diffuse metastases are treated with radiation and chemotherapy. A short-term freedom from complaints is thereby realized. In rare cases, recovery actually occurs.
However, this is typically followed by renewed cancer. A bone marrow biopsy promises clear results. Life expectancy is shortening again. It is not uncommon for bone marrow carcinosis to bring with it questions about life and psychological problems. This can be encountered in the context of therapy.
You can do that yourself
People who have been diagnosed with bone metastases can usually only be treated palliatively. The most important self-help measure is to obtain information about the bone marrow carcinosis and its course. This often makes it easier for those affected to accept the disease. Attending a self-help group helps to have a more positive outlook, and patients often learn new strategies for dealing with their symptoms by talking to others who are affected.
Accompanying this, medical treatment is always required. Because radiation therapy places a considerable strain on the body, the patient needs a lot of rest and protection. The doctor in charge will also recommend an individual diet for the patient. In cooperation with a physiotherapist, a training plan is drawn up that ensures the functionality of the affected bones and, in the best case, improves the patient’s well-being.
The individual symptoms such as pain or the typical feeling of illness can also be alleviated by alternative remedies. Which measures make sense here in detail is best answered by the responsible doctor. Despite all these measures, bone marrow carcinosis often ends in the death of the patient. The support of friends and relatives is therefore all the more important.
