Abstract. Background: Bone is a frequent site of metastases in advanced cancer and is associated with significant skeletal morbidity. Current treatment options. Cancer that begins in an organ, such as the lungs, breast, or prostate, and then spreads to bone is called metastatic bone disease (MBD). More than million new cancer cases are diagnosed each year. Approximately 50% of these tumors can spread (metastasize) to the skeleton. Metastatic bone disease develops as a result of the many interactions between tumour cells and bone cells. This leads to disruption of normal bone metabolism.


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Bone metastasis

Risk factors Virtually any type of cancer can metastatic bone disease to the bones, but the cancers most likely to cause bone metastasis include: High calcium can cause constipation, which can result in abdominal pain, and with very high calcium levels, confusion and mental status changes can occur.

Diagnosis of Bone Metastasis Once a patient experiences any of the symptoms of bone metastasis, various tests can be done to find the true cause. In some cases, bone metastasis may be detected before the metastatic bone disease arise.

X-rays, bone scans, and MRIs are used to diagnose bone metastases. X-rays are especially helpful in finding osteolytic lesions.

Metastatic bone disease: clinical features, pathophysiology and treatment strategies.

These often appear metastatic bone disease "holes" or dark spots in the bone on the x-ray film. Unfortunately, bone metastases often do not show up on plain x-rays until they are quite advanced.

By contrast, a bone scan can detect very early bone metastases. Metastatic bone disease test is done by injecting the patient with a small amount of radio-tracing material in the vein.

Special x-rays are taken a short time after the injection. The radiotracer will go to the site of the metastases and will appear as a darker, denser, area on the film.

Bone metastasis - Wikipedia

However, because this technique is so sensitive, sometimes infections, arthritis, and old fractures can appear as dark spots on the bone scan and may be difficult to differentiate from a true cancer.

Bone scans are also used to follow patients with known bone metastasis. Sometimes CT scan images can show if a cancer has spread to metastatic bone disease bone. An MRI is most metastatic bone disease when examining nerve roots suspected of being compressed by tumor or bone fragments due to tumor destruction called spinal cord compression.

There are no blood tests that are currently used to diagnose a bone metastasis. There are, however, a number of blood tests that may suggest the presence of bone lesions, but the diagnosis rests with the combination of radiology testing, clinical picture symptomsand the type of cancer is it one that travels to bone?

This metastatic bone disease to disruption of normal bone metabolism, with the increased osteoclast activity seen in most, if not all, tumour types providing a rational target for treatment.


With MRI very small skeletal metastasis can be detected. MRI is favored for detection of vertebral metastasis and evaluating their association with the spinal cord.

These advantages and the multi-planar imaging capability make MRI a helpful imaging tool in preparation for surgical and radiation procedures 27 For initial staging of cancer disease or in the context metastatic bone disease follow-up examinations in disease-free patients, nuclear bone scintigraphic imaging with Technetium 99mTc is widely accepted since it evaluates the whole skeletal system and is relatively inexpensive.

Osteolytic metastasis with minimal osteoblastic bone formation can, thereby, produce metastatic bone disease negative bone scans.

In disease-free patients and in the absence of other metastasis in metastatic bone disease follow-up examinations, a biopsy may be necessary to confirm metastatic disease. Novel imaging technologies with projected increased sensitivity and specificity have not been adequately tested in prospective trials if they offer additional value in terms of impact on skeletal morbidity and survival through metastatic bone disease and more reliable detection of metastasis 30 Treatment of Vertebral Bone Metastases When cancer metastasizes to the bone, the axial skeleton is preferred.

Within the axial skeleton, the vertebral column is most often affected. When treating metastatic lesions to the bone, a multidisciplinary approach is necessary to gain local control over the lesions by means of radiation therapy or surgery.

Bone Metastasis Treatment with Medications | OncoLink

We propose, metastatic bone disease, algorithm II for treatment of vertebral bone metastasis in Figure 2. When tumor masses and pathological fractures of the vertebra cause compression of myeloradicular structures i. To provide temporary relief of symptoms related to pressure and edema secondary to tumor mass a therapy with corticosteroids should be concurrently initiated Different factors must be considered when choosing the aggressiveness of the surgical intervention.

Besides the preoperative neurological condition and the performance status, the aggressiveness of the primary tumor and the life expectancy of the patient are the determining factors In advanced cancer diseases, a palliative decompression and stabilization, followed by radiation therapy, can improve the quality of life.

metastatic bone disease

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