Bone metastasis

How big is the problem?

The population incidence of cancer is about 0.5%. This roughly translates to 27,000 patients in Singapore (with an assumed population of 5.4 million). It has been estimated that about 60% of patients with cancer will develop bone involvement. Hence, the estimated disease load projected by this condition could be up to 16,200 patients per year. About half to a third of this number can benefit from surgery in one form or another. The rest are managed by various combinations of chemotherapy, radiation therapy and palliative procedures.

Bone Metastasis FAQ

Can surgery improve the quality of life for patients with bone metastasis? Yes. For many patients, the goal of surgery is not just to treat the tumor, but to stabilize the bone and eliminate pain. By performing specialized procedures like hip reconstruction or prophylactic nailing, we can prevent pathological fractures, allowing patients to remain mobile and significantly improving their daily comfort and independence.

How do you decide between surgery and radiation therapy? The choice depends on the "Mirels’ Score," which assesses the risk of the bone breaking. If the bone is structurally compromised, surgery is often the first step to provide mechanical stability, followed by radiation to treat the local cancer cells. If the bone is still strong, radiation or systemic therapy may be used alone.

What is the role of palliative surgery in bone cancer? Palliative surgery is focused on symptom control rather than a cure. We use minimally invasive techniques, such as percutaneous cement injection (vertebroplasty) or cryoablation, to target painful lesions in the spine or pelvis. These procedures can be performed with minimal downtime, ensuring the patient can continue their primary cancer treatments without interruption.