Survival with Bone Metastases

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Survival for Patients with Bone Metastases

Note that the survival of patients with early bone metastases may be very long from the time of the initial development of bone metastases. For instance the median survival of a woman with breast cancer from the time of a first bone met is almost 4 years (and if the cancer responds well to hormonal therapy it is not uncommon to live much more than 5 years.)

Similarly the median survival of a man with prostate cancer from the time of first spread to the bone is 3 years (and again, if the tumor responds well to hormones many men live much longer than 5 years. (Also remember that median is the point when half the patients have died but half are still alive.) The survival with hormone resistant Stage D prostate cancer is shorter, see nomogram.)

The survival stats below are generally for patients with cancer, no longer responding well to chemotherapy or hormonal therapy and then referred for radiation (so by definition more advanced cancer and late in the life cycle, as discussed above many patients with bone metastases may live for years if they have a slow growing cancer opr a cancer that is still responding to hormone or chemotherapy.)

**Survival with Bone Mets and Radiation from the RTOG Trials**
Source	Solitary	Multiple
Breast	73 weeks	34 - 48 weeks
Prostate	39 weeks	25 - 30 weeks
Other	33 weeks	16 weeks
Lung	14 weeks	12 -22 weeks

There are many statistics predicting length of survival in patients with bone metastases to the spine, that show the variation based on how weak or sick the patient is (the Karnofsky score or KS) the histology of the primary source (breast cancer is better, lung cancer is worse) the extent of other sites of spread (spread to other organs like the lung, liver or brain (visceral) do worse) and patients who respond to treatment do better, as noted below:

Survival for patients with spinal bone mets is based on several considerations: (see graph ,table, data and data and data)
- responders live longer (9.5 months versus 2 months)
- ambulatory patients live longer than paralyzed (10 months versus 1 month)
-favorable histologies (myeloma, breast, lymphoma) live longer than other types (12 months versus 4 months)