Monitoring Bone Metastases
Once you’re diagnosed with bone metastases, you and your doctors will decide on a treatment plan. Part of that plan will involve tests that show how well treatment is working and how strong your bones are. These tests are important. They can show whether the bone metastases are growing, spreading, or staying the same, so you and your doctor can continue making treatment decisions and manage side effects.
Your doctor may use some of the same tests to monitor bone metastases that were used to diagnose them. This will likely include imaging tests like x-rays, CT scans, MRIs, PET scans and bone scans. These tests create pictures of your bones. By comparing the pictures over time, doctors can see if metastatic breast cancer tumors in the bones are growing, shrinking or changing in other ways in response to treatment. The pictures will also show doctors how strong your bones are, and whether a bone is at risk of breaking. If they see that your bones are at risk of breaking, they can recommend treatments to prevent it.
You may also get blood tests to look for proteins or cells that have broken away from the tumors and entered your blood. This is called a tumor marker test. Cancer cells that enter your blood could spread and form tumors in other parts of your body. If doctors find cancer cells in your blood using a tumor marker test, they can try to prevent that from happening by changing your treatment to get the cancer under better control.
Another type of blood test called a blood chemistry test may be used to look for high levels of calcium in your blood. High levels of calcium suggest the bones aren’t building up and breaking down the way they should be, which can be a sign that treatment isn’t working well enough and tumors in the bones are growing or spreading.
How often you get which tests depends on your diagnosis and your doctor’s preferences. But it’s common for doctors to recommend imaging tests every 2-6 months for bone metastases. If he or she recommends blood tests, a common schedule for tumor marker tests is every 1-3 months and a common schedule for blood chemistry tests is every 3-6 months.
Your doctor may also recommend additional tests if you experience bone-related symptoms or side effects. Ask your doctor how often he or she recommends you have certain tests, and why.