Statistics in 2007 showed that cancer has become the number one killer in China. In recent years, with the invention and application of various treatment methods, the survival period of cancer patients has been prolonged and the incidence of distant metastasis has increased significantly. Bone is the third most common site of cancer metastasis, after lung and liver. Among them, breast cancer, prostate cancer, lung cancer, thyroid cancer and kidney cancer are the five cancers most likely to metastasize to the bone, which we call pro-bone malignancies. Once bone metastases are detected, it is often a difficult task for patients, families and doctors to decide whether to treat or not. Of course, local radiotherapy for bone metastases is still easily accepted by most people. However, it is often difficult for oncologists or primary cancer physicians such as general surgeons and urologists to decide whether surgery is needed. In this case, the patient’s family should consult with a bone tumor specialist to determine whether surgery is needed. As to whether a patient with bone metastasis needs surgery, a bone tumor specialist should weigh the pros and cons of surgery according to the patient’s condition, location and systemic condition to determine whether surgery is needed.