Klin Onkol 2004; 17(1): 29-32.
Summary: Bone metastases are a common cause of morbidity in patients with many types of cancer, including breast, prostate and lung tumors. In the pathogenesis, interactions of different cytokines (e.g. IL-1,IL-6, TNF, TGF® , osteoprotegerin) play a role, resulting in activation of osteoclasts and bone resorption. Diagnosis is based on imaging methods (simple radiography, scintigraphy, CT, MR) and on biochemical examination (degradation products of collagen, calcium level). The goals of treatment for bone metastases are to reduce the occurrence of skeletal-related events ( pain, hypercalcemia, pathologic fractures and spinal cord compression) and to improve quality of life. Current management of skeletal lesions involves a multimodality approach including surgery, radiotherapy and particlularly systemic therapy (chemotherapy, hormonal therapy, bisphosphonates). Bisphosphonates not only reduce the pain but effectively decrease serum calcium level by interfiering with osteoclast activity.
