A Cross-Sectional Study on the Status of Female Lung Cancer Patients With Bone Metastasis With or Without Osteoporosis.

BACKGROUND AND AIMS: Late-stage lung cancer (LC) often leads to distant metastasis to the skeletal system. Furthermore, there is a probability of 32.1% of osteoporosis development in women over the age of 50. Both bone metastases (BM) and osteoporosis cause bone pain. However, research is still limited on the differences in pain and psychological distress between LC patients with and without osteoporosis. Therefore, we aimed to investigate the differences in pain and psychological distress levels among female LC patients with and without BM and osteoporosis.

METHODS

The study focused on the incidence of BM in female LC patients (aged 36-87 years and untreated) with or without osteoporosis. A prospective research analysis was conducted to examine the specificity of pain and psychological distress. BM was diagnosed according to the guidelines for BM in patients with LC and confirmed through whole-body bone imaging and PET-CT. Osteoporosis was diagnosed according to "Guidelines for the Diagnosis and Treatment of Primary Osteoporosis" (2017), which recommend bone density measurement for confirmation.

RESULTS

Patients with LC (n = 176, 59.4%), with LC and BM (n = 82, 27.7%), with LC without BM but with osteoporosis (n = 12, 4.1%), and with LC and BM in combination with osteoporosis (n = 26, 8.8%) were included. Importantly, the incidence of osteoporosis in BM group was greater than that without BM. According to the multivariate regression, LC patients with both BM and osteoporosis experienced more severe pain and higher levels of anxiety and depression than those with BM alone.

CONCLUSION

This study revealed differences in pain levels and psychological distress between female LC patients with BM and those with BM complicated by osteoporosis. These findings underscore the need for integrated clinical management strategies, such as implementing routine osteoporosis screening for this population and developing tailored pain management and psychosocial support protocols to improve overall care outcomes.