Pain Pain is the most common symptom of bone metastasis of lung cancer, due to the stimulation and destruction of periosteum by tumor. Usually, the location of pain is relatively fixed and generally confined to the site where metastasis occurs, such as rib metastasis, which will have clear pressure points and sometimes breathing pain, and vertebral metastasis which will cause neck pain, back pain, lumbar pain, etc. Percussion on the top of the head will cause vibration pain of the corresponding vertebra. Fractures of this kind we generally call pathological fractures, distinguished from fractures caused by external violence. It is characterized by a fracture that can be caused by a slight external force, or a fracture that occurs without any external force at all. The cause is the destruction of bone. In bone metastases caused by lung cancer, more than 80% of them are osteolytic destruction, which is commonly known as “the bone is eaten by the tumor”. This is manifested as bone loss on imaging, which greatly reduces the strength of the bone and makes it easy to fracture. In less than 20% of cases, the osteogenic damage is combined with a mixed type of damage. The clinical consequences of fracture are: inability to move the corresponding part, or even paralysis and bedridden if the vertebrae are fractured. What is the treatment of bone metastases? First of all, after a painful or unexplained fracture, a skeletal examination should be done quickly to determine whether there is bone metastasis or the severity and type of metastasis. General X-ray, CT, MRI or bone ECT can be done, and PET-CT is also a good choice if the financial condition allows. 1.With widespread and multiple bone metastases throughout the body, especially with metastases from other organs, systemic treatment, such as chemotherapy or targeted (with indications), combined immunotherapy (with indications), is used to control bone destruction only if the tumor is controlled. 2.Only bone metastasis, no other organ metastasis, and/or accompanied by obvious bone pain in the whole body, you can choose nuclear vein therapy, which has special affinity for bone metastasis and will focus on the metastasis site, such as strontium 89, which usually has good effect on tumor control and pain relief. 3. Drug treatment. Along with the above treatment, intravenous injection of bisphosphonate is used to protect and repair the bone destruction, which also has a certain effect on pain relief. 4.Radiotherapy. For single bone metastases, or certain bone metastasis sites causing severe pain in multiple bone metastases, or bone metastases with particularly important location (such as vertebral metastases compressing the spinal cord), local radiotherapy can be adopted, which has good pain-relieving effect and can control the tumor and reduce complications. Since it is palliative treatment, it is usually done a dozen times, which is not long and the cost is very low. 5.Anti-pain treatment. For the pain that occurs throughout the body, if the above treatment cannot be effectively controlled, pain relief drugs should also be taken in a standardized way. We don’t have to worry about addiction or the effect getting worse, now we have many ways to deal with these problems. The principle is, don’t tolerate pain. Because pain causes physical adverse reactions, it is more serious than those problems. 6.Bone metastasis can also cause hypercalcemia in some patients, which requires regular blood calcium checks and treatment with medication. 7.Treatment of hematopoietic suppression. Bone metastases sometimes cause bone marrow infiltration, leading to hematopoietic dysfunction, which needs to be treated with drugs that promote hematopoiesis. Bone metastasis of lung cancer usually does not cause fatal problems, so it is still different from metastasis of other organs. Patients actively cooperate with treatment to help reduce pain and improve survival quality.