Diagnosing and Treating Bone Problems

When a bone metastasis is suspected, imaging tests are used to determine its presence or absence. The tests used depend on the person’s individual situation, and may include:

  • X-rays
  • Bone scans (bone scintigraphy)
  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET)

Additionally, doctors use a variety of tools to monitor your bone health as you go through cancer treatment. The following tests can tell you and your doctor what your bone density is, how much risk you might have for bone fractures and whether the condition of your bones is changing either because of your cancer treatment or because of the cancer itself.

DEXA scan. This test measures the density (mass) of the bones. It shows whether your bone density is normal or whether you have osteopenia (mild bone loss) or osteoporosis (significant bone loss) which increases the risk of fractures.

FRAX. Your doctor may use this tool to evaluate your risk of fracture. FRAX takes a number of factors into consideration, including age, gender, height, weight, whether you smoke, past history of fractures and whether you take medication for an existing bone condition, such as osteoporosis. It is often used in conjunction with the DEXA scan.

Blood tests. Your doctor may also check to see if you have high levels of calcium in your blood, a condition called hypercalcemia. This situation can happen when cancer injures the bones, causing calcium to be released from the bone into the blood. Symptoms of high calcium levels may include nausea and vomiting, sleepiness, feeling very thirsty and frequent urination.