Cancer can spread from its initial site of appearance to other parts of the body. Tumor cells from the primary site are transferred to other parts of the body through the blood and lymphatic channels, or by other means. The tumor growing at the metastatic site is not a new type of tumor, but still originates from the primary tumor and has the same cell type as the primary tumor. The term used to describe the spread of a tumor is metastasis. Metastasis-prone tumors: prostate, breast, and lung cancers Bone metastases are one of the most common complications of malignant tumors, and many solid tumors are prone to appear in bone tissue. The most common is prostate cancer, and even 90% of patients can develop bone metastases, and many prostate cancer patients have already developed bone metastases by the time they are diagnosed. This is followed by breast cancer and lung cancer. Although the probability of bone metastasis in lung cancer is not as high as that in breast cancer, the absolute number of patients with bone metastasis is higher than that in breast cancer because of the large number of lung cancer patients in China. In addition, early breast cancer has a better chance of detection, which also makes the number of breast cancer bone metastases relatively less. Reasons for misdiagnosis: Initially, they are often treated as herniated discs Bone metastases like to metastasize to weight-bearing bones, such as the spine, flat bone (pelvis), ribs, thigh bone (femur) and skull. The most common misdiagnosis of bone metastases is as a herniated disc. If treated as lumbar disc herniation, massage or surgery will accelerate the destruction of the bone, and once fractured, it will cause paraplegia and leave the patient with lifelong regret. Therefore, we should be especially vigilant. When a patient sees a doctor for the first time, it is best to do MRI or CT of the lumbar spine to clarify whether there is any primary disease. Isotope bone scan and PET-CT, which can reveal metabolism and rich blood flow at the site of bone metastasis, show that there may be metastasis tumor. However, sometimes the isotope bone scan will show abnormal metabolism at the site even if the arm and elbow are gently touched. Therefore, these two tests have a high rate of false positives. Warning signs: having the following symptoms are mostly bone metastases Symptom 1: pain, mostly fixed on one point (local); gradually aggravated, light during the day and heavy at night. The earliest symptom of bone metastases in certain tumor patients is pathological fracture. Symptom 2: In late stage with compression fracture, pain is strung to the thoracic spine and under the belt, radiating to the thigh area. Patients often have difficulty walking. Symptom 3: Bone pain. Initially, the symptoms are transient and persist as the disease progresses and worsen with exercise. Symptom 4: High levels of calcium ions in the blood trigger hypercalcemia, resulting in lack of appetite, nausea, thirst, fatigue, muscle weakness, irritability, and confusion. Other symptoms include paralysis of the lower extremities, weakness, problems with urinary and fecal excretion, or abdominal paralysis. Treatment options: treat both primary disease and metastases Once a patient is diagnosed with bone metastases, the primary disease should first be treated according to the guidelines so that the cause of the disease is addressed and the metastases can be controlled. Then, the local lesions should be treated, such as local radiotherapy, and orthopedic surgeons should be consulted for repair surgery when fractures occur. Bisphosphonates are an important adjuvant treatment for bone metastases with limited anti-cancer effects, but they can inhibit osteoclasts, inhibit the entry of bone salts into the bloodstream, reduce pain and prevent related bone events. Once bone metastases are diagnosed, treatment with bisphosphonates should be routinely used even if there are no clinical symptoms such as bone pain. Bisphosphonates should be used consistently for at least two years or longer. The longer the treatment, the more it can improve the quality of life of patients with advanced tumor bone metastases and further prolong the survival time of patients. In my opinion, since bone metastases are bound to appear, as long as there are no drug side effects, the cost is not a problem and the patient can accept it, in principle, it should be continued until the patient cannot tolerate it or the general condition declines significantly. It is especially important for patients to follow medical advice. Once bone metastases are detected, the drug should be administered regularly, i.e. 1 intravenous bisphosphonate once a month. Regular use of the drug minimizes the risk of bone-related events and provides a greater survival benefit.