Perspective Chapter: Bone Metastases of Solid Tumors

Abstract

Bone metastases are more common than primary bone cancers, especially in adults. Bone is the third most common organ affected by metastases, from many types of solid cancers but especially those arising in the breast and prostate. Besides the impact on survival, bone metastases may have a big impact on morbidity and represents a significant healthcare burden. Skeletal-related events (SREs) include pain, pathologic fracture, spinal cord compression, and hypercalcemia and can cause a deterioration of the quality of life. Detection of bone metastases is essential for accurate staging and optimal treatment; however, there is no consensus or standard approach for diagnosis, so the choice of imaging should be guided by clinical presentation. Treatment goals may consist of controlling pain and other symptoms, preserving and restoring function, minimizing the risk of SREs, stabilizing the skeleton, and enhancing local tumor control. Therapeutic options include pain management/analgesia, osteoclast inhibitors, systemic anticancer therapy, radiation therapy, bone-targeting radiopharmaceutical therapy, surgery, and/or image-guided thermal ablation. The choice of treatment is influenced by factors like symptoms, impact on quality of life, performance status, estimated life expectancy, goals of treatment, and preferences of care.