Extremity metastatic disease

Extremity metastatic disease is a type of cancer that develops in the extremities of the body. It affects the arm and leg bones like the humerus. Accordingly, the cancer is called upper extremity cancer or lower extremity cancer.

Cancer starts when the other parts of the body like the lungs, breasts, or prostrate develop cancer. Then the tumor spreads to nearby extremities or the spine.  This process is known as metastasis.

Cancers initiate in the lungs, liver, kidneys, thyroid, prostate which later spread to bones. Treatment is available for the cancers that occur at these places. However, after they spread to bones, it becomes difficult to restrict cancer.

Moreover, upon their expansion to bones, these tumors make the bones weak. Due to this, fractures may occur. Thus, it becomes necessary to limit the growth of tumors at a suitable time.



The main cause for this cancer is the metastasis of the cancerous cells to limb bones. The cancers originate at a different place and then affect the bones. Formation of lesions or degradation of bones occurs during this process.



Pain: Pain is the most common symptom of an extremity metastatic disease. This pain results due to the weakening of the bone at the place of the tumor. Thus, experiencing pain in the extremities is by far the most common sign.

Fractures: Bones can break quite easily due to this cancer. This leads to the fracture of your bones, even from a minor injury.

Anemia: Areas like arms, long bones of the leg are responsible for the formation of blood cells. This is because of the presence of bone marrow which contains blood cell forming machines. One type of cell produces Red blood cells, which are necessary for carrying oxygen to tissues in the body. Therefore, damage to the extremities can result in anemia.


How your doctor detects the tumor?

The detection and examination of this tumor will begin with the physical examination. Before the imaging tests, a doctor will look into your medical history.


He/She will ask for a family history of this cancer, whether or not you are smoking, and your dieting habits. Then the doctor will look for lesions or swelling in the area of the tumor.


After a thorough physical examination, your doctor will order other tests. These tests help to confirm the malignancy. These tests will help find if the tumor is malignant or non-malignant. A destructive bone lesion is present in case of a malignant one.

However, a nonmalignant tumor can cause other conditions like hyperparathyroidism (the increasing activity of the parathyroid gland and osteoporosis (dissolving of bones). Different tests help in the confirmation of these.

Among imaging tests, an x-ray is highly useful. This helps your doctor detect the location of your tumor and the damage. However, for confirming the actual size and other details like the complexity of the tumor, your doctor will order other tests.

These tests include Computed tomography (CT) scan, Magnetic resonance imaging (MRI) scan, or a bone scan.

An MRI is done when you lie still and flat on a plain surface. Then, this surface will take you inside an MRI machine that has a tube shape. To create a detailed, 3-D image inside your body, it uses radio waves and a magnetic field.

Similar to the MRI, your doctor may also perform a CT scan. It connects with a computer and takes pictures.

A bone scan is also good at most times. During this test, the injection of a tiny amount of radioactive dye is given intravenously. These tumors appear as a “hot spot” at the place where the tumor is present when they uptake the radioactive material.

To confirm the diagnosis of extremity metastatic cancer, a biopsy is the ultimate answer.  In a biopsy, your doctor takes a sample of tissue from the tumor and examines it under a microscope.

Before the operation with a needle, your doctor will give you anesthesia locally. Your doctor may use a needle to insert into your extremities or remove a part surgically.



The treatment of the tumor depends upon the extent of the disease and size. Your doctor may try to first relieve your pain by various mechanisms. Preserving the function of the area is also a priority for the patient. Thus, your doctor will try his/her best to treat the tumor in a way that doesn’t affect the function of extremities.

To reduce the size of lesions in your bones, your doctor may use bisphosphonates. This is because they are quite helpful in degrading the lesions. Similarly, to reduce the pain, your doctor may use external beam radiation therapy (XRT) as well.

Besides this, this helps to stop the metastasis of the tumor to other parts of the extremities. Your doctor may also use radiation therapy if the tumor is small or present in the area where surgery is not possible. This weakens the tumor and restricts its expansion to other parts.

Surgery is the last and ultimate option. If the tumor doesn’t stop the growth or has spread to a larger area, surgery may rescue you. Further, the type of surgery varies depending upon whether the tumor is present in the upper or lower extremities.

After removing the tumor by surgery, your doctor may order the periodical radiation therapies to kill the remaining tumor cells, if any. Also, before surgery, you may need to undergo a preparative phase.

Coping and support 

When you get diagnosed with extremity metastatic cancer, it could be frightening for you as well as your family. You may learn to cope with the uncertainty and distress related to cancer with time.  You need to follow these instructions until then;

Call on for medical support:

Various things are going to help you. The knowledge and understanding of a medical social worker, or any other mental health professional will help you in understanding your cancer.

If your child or other family member suffers from cancer, you need to ask health care professionals for advice. They will provide you with options for medical health support as well as emotional and social support.

In addition to this, you can check various online services that will provide you support to combat cancer.

  • Gain more knowledge about extremity metastatic cancer to make decisions about control and care:

Ask your doctor about various treatment options related to extremity metastatic cancer. Little knowledge is dangerous. Therefore, more confidence in understanding and making decisions about treatment options will be there with you. So you should always learn more about the disease.

Ask the health care team for guidance if your child has cancer. Get more and more information for appropriately caring for the patient.

Be close to your friends and family:

A close and strong relationship with your family and friends will help you deal with extremity metastatic cancer.

You need practical support, moral support from your friends and relatives. Someone should be there for you to look after the family. Emotional support from them is going to matter most. A healthy and happy person will ultimately efficiently fight the disease.

Prepare for your appointment

You are likely to start making an appointment with your primary care doctor if some signs and symptoms worry you. Ask for a referral to an experienced specialist if your doctor suspects extremity metastatic cancer.

A team of specialists typically can treat extremity metastatic cancer. For instance;

Orthopedic surgeons or orthopedic oncologists who have specialization in operating bone cancers.

Doctors who have a specialization in treating cancers with systemic medications or chemotherapy.

Pathologists diagnose the specific type of cancer by analyzing a tissue.

Rehabilitation specialists who after surgery help in the recovery of a tumor.


What you should expect from your doctor:


You will face several questions from your doctor. You should be ready to answer to give more time to your doctor to address them. Your doctor may ask;

What signs and symptoms concern you more?

Have your symptoms been occasional or continuous?

When did you start to notice the symptoms?

The severity of your symptoms?

Is there anything that improves your symptoms?

Is there anything that worsens your symptoms?

Do you have any family or personal history of cancer?