How to treat primary cancer with lung nodules and bone loss?

Hi doctor,

I wondered if someone could help me interpret the following recent CAT (computerized axial tomography) scan. My husband has stage 4 unknown primary cancer in the bones and lymph nodes. Is this report saying he now has cancer in the lungs, and how will this disease progress?

He is not doing conventional treatment, just riding it out on Morphine for pain. The widespread osseous metastatic cancer, a stable small right pulmonary nodule with metastatic disease, is not excluded in this clinical setting. The lung nodules are suspicious for metastasis, lymphadenopathy potentially secondary to neoplastic involvement, and mild lactic change at the lung bases.

A new nondisplaced, probably a pathologic fracture at the right anterolateral sixth rib. Does this mean ribs will keep fracturing, and if cancer is now in the lungs, does that mean there is faster growth?

Thanks.

Hello doctor,

Thanks for the reply.

He already had numerous biopsies done, and they cannot find a primary. He has cancer all over his bones and in his lymph nodes. He is on Morphine to manage the pain and palliative care to ride out the disease. I asked in my above question, is it in the lungs now, and if so, will this move faster, and will the pathological fracture in the rib heal, or will his bones just continue to fracture now?

Thanks.