Skeletal Metastases: Optimal Management Today

  • John Kosteva*
  • Corey Langer
Part of the Cancer Drug Discovery and Development book series (CDD&D)


The skeletal system is a frequent site of metastatic involvement in patients with advanced malignancy, especially in those with breast and prostate cancer, lung cancer, and myeloma. Skeletal metastases involve an imbalance between the osteoclastic and osteoblastic activity of normal bone remodeling. Skeletal metastases may result in various complications, also known as skeletal-related events, including pain, pathologic fractures, hypercalcemia, and nerve or spinal cord compression. The consequences of skeletal metastases and their treatment may have a substantial impact on health care economics. Skeletal metastases can be detected by a variety of radiographic and nuclear imaging modalities. In the modern era, PET imaging may ultimately supplant bone scan as a diagnostic approach. Treatment for skeletal metastases includes rest and analgesics, bisphosphonates, radiation, radionuclides, and surgery. In addition, standard systemic approaches for the underlying cancer may help palliate osseous involvement.


Bone metastases Skeletal metastases Bisphosphonates Skeletal-related event Zoledronic acid Pamidronate Radiotherapy Radionuclides Economic Imaging 


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Copyright information

© Humana Press, a part of Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • John Kosteva*
    • 1
  • Corey Langer
    • 1
  1. 1.Fox Chase Cancer CenterPhiladelphia

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