Abstract

Bone metastases have long been considered the end-stage of cancer. However, the prognosis is improving. Bone metastases rarely cause death but, due to bone pain, pathologic fractures, functional impairment and hypercalcaemia, they are a significant source of morbidity. Treatment is determined by the patient’s prognosis: short anticipated life expectancy warrants palliative therapy: mostly pain relief and radiation; more radical treatment should be undertaken in patients with a better prognosis: namely, resection and/or reconstruction of the lesion together with adjuvant radiotherapy. In certain cases, impending pathologic fractures should be stabilized. Treatment is to be managed by a team of specialists, including radiologists, pathologists, both medical and radiation oncologists, orthopaedic surgeons, and pain management specialists. The art of treating patients with metastatic bone disease lies in finding the best palliation with minimal side effects.