The diagnosis and management of metastatic bone disease in general practice

Abstract

As cancer treatment improves and survival rates continue to increase, clinicians are seeing increasing numbers of patients with metastatic bone disease (MBD). This term describes cancer that has originated in another organ and subsequently spread to the bone. It is a condition that can severely impact the quality of life for an individual and the treatment is often not curative. This article aims to cover the management of MBD, from early recognition to secondary care interventions. The care of individuals with MBD is evolving in the UK, with the development of specialist regional referral pathways to facilitate prompt and timely management.

Early imaging to detect bone metastatic disease of a 54-year-old woman with history of breast cancer: a case report

“…10 The most common symptom is pain and normally experienced around the site of the metastases, although sometimes can be referred to other areas from the affected structure. 2 This pain is caused by the release of cytokines and neuropeptides acting on the endosteum and subsequently the periosteum, as the tumour affects cortical bone. 2 Particular attention must be given to patient presenting with musculoskeletal pain and a background of cancer.…”

“…2 This pain is caused by the release of cytokines and neuropeptides acting on the endosteum and subsequently the periosteum, as the tumour affects cortical bone. 2 Particular attention must be given to patient presenting with musculoskeletal pain and a background of cancer. 2 Commonly in patients who report functional pain, describing pain that comes on when completing everyday activities or experience difficulty weight bearing.…”

“…2 Particular attention must be given to patient presenting with musculoskeletal pain and a background of cancer. 2 Commonly in patients who report functional pain, describing pain that comes on when completing everyday activities or experience difficulty weight bearing. 2 Importantly, simple analgesia has no effect on relieving this pain, which can help differentiate it from other musculoskeletal problems.…”

“…1 After the lungs and liver, bone is the third most common site of tumour spread. 2 The bone is a dynamic tissue that plays a critical role not only in structural support and movement, a reservoir for minerals and energy, but also houses of the bone marrow, which is the main site of postnatal hematopoiesis. 3 The incidence of bone metastasis in all cancers is approximately 3-5%, and rises significantly to 19% in cancers affecting the prostate, lung and breast.…”

“…3 The incidence of bone metastasis in all cancers is approximately 3-5%, and rises significantly to 19% in cancers affecting the prostate, lung and breast. 2 The early diagnosis of skeletal metastases has a major impact on the overall treatment strategy and is an important determinant of the course of illness and the quality of life. 4 The goal of diagnostic imaging is to detect skeletal metastases early, whenever they are suspected on the basis of clinical, laboratory findings, or in patients who are at high risk.…”