Medical Prevention and Treatment of Bone Metastases

The presence of metastatic bone disease is a devastating complication that has signifcant impact on morbidity and mortality in cancer patients. Although the type, incidence, and consequences of bone metastases (BM) may vary between primary cancer sites, all patients with BM require consideration as to how both their primary tumour and their bone disease should be managed in terms of avoiding complications and maximizing both quality of life and survival. This chapter will describe normal bone turnover, the pathophysiology of BM, and the most common clinical sequelae. We will then explain the current evidence for the prevention and treatment of BM for the most osteotropic tumours (breast, prostate, lung, and renal).