Background: Bone metastasis is a relatively frequent complication of cancer, often occurring as cancers progress, particularly in prostate and breast cancer. The bone is the most common and favored site for cancer to spread. During the advanced stages of cancer, bone metastases frequently develop. Aims of the study: The study aims to determine the prevalence of secondary bone tumors and bone-related symptoms among various primary cancer sources in Basra city Oncology center. Patients and methods: The study included (124) cancer patients aged (18 to 80) years with bone metastases. The patients were treated at the Oncology Centre in Basrah city between April 2022 and July 2023. Voluntarily participants were enrolled and provided with written informed consents. The study was approved by the Ethical Committee of the University of Basrah, College of Medicine. Patients completed a questionnaire covering socio-demographic information and pain history. PET scan and X-ray results were evaluated by a single observer to determine metastasis sites and bone lesion appearance on X-rays. Primary tumor information was extracted from patient’s medical records.Results: The study cases had an average age of (67.0±9.2) years. Males constituted 79(56.5%) of the cases, while females constituted 54(43.5%). The distribution of primary malignancies significantly differed by gender (p<0.001). Prostate cancer exclusively affected males (85.7%), while breast cancer was exclusive to females (81.5%). Lung and unknown primary sources of cancer had lower prevalence in both groups. Regarding secondary bone tumors, spinal involvement was the most common in both females (72.2%) and males (68.6%), without a significant gender difference (p=0.11). Pain site exhibited a significant gender disparity (p=0.002), with localized pain was more common in females (74.1%), and generalized pain was more prevalent in males (54.3%). X-ray findings were also significantly correlated with gender (p<0.001), with blastic lesions mainly seen in males (94.3%) and lytic lesions were more prevalent in females (88.9%). Mixed lesions were rare and only found in males (7.4%). The distribution of secondary sites varied significantly among cancer types (p<0.001), with the spine being the most affected site across all groups. Pain site and severity also highly significantly differed among cancer types (p<0.001). X-ray findings demonstrated highly significant differences (p<0.001), with prostate cancer showing a predominance of blastic lesions (100.0%), breast cancer predominantly displaying lytic lesions, and lung cancer having an equal distribution of blastic and lytic lesions among cases.Conclusion: The spine was identified as the primary site for metastatic involvement. Pain intensity showed variability, with moderate pain affected (41.9%) of patients, severe pain affected (29.8%), and mild pain was reported in (28.2%) of the cases. Prostate cancer was strongly associated with blastic lesions (100%) of cases, while breast cancer was significantly linked to lytic lesions on X-rays (90.9%) of cases.

Keywords: Bone metastasis, Bone pain, Bone changes, Cancer