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Radionuclide Bone Scintigraphy
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Kanhaiyalal Agrawal, Gopinath Gnanasegaran
Bone is the third most common site of metastasis after lung and liver [13]. The majority of metastases in the bone are hematogenous in nature. Mostly, the spread to bone occurs through the normal venous system or through Batson’s plexus. Through this, tumour cells enter into the red marrow of the medullary bone. These cells attach to endothelial surfaces, multiply, and invade the bony structures to include the cortical bone [14]. These cells then induce osteolytic activity by secreting various factors. The parathyroid hormone-related peptide (PTHrP) has a dominant role in the development of lytic metastasis. The receptor activator of NF-kappaB (RANK) ligand has a major role in the formation of osteoclasts by stimulating precursor cells when it binds to the receptor activator of RANK on the cell membrane of osteoclast precursors [15]. The ongoing bone resorption induces a reparative response in the adjacent normal bone, that is, an osteoblastic reaction. However, some of the metastatic cells directly secrete local substances, like transforming growth factor, bone morphogenic proteins (BMP) and endothelin-1: Those are associated with osteoblast generation. In general, malignancies that are rapidly growing produce osteolytic lesions. Hence, the metastatic cells can induce either osteolytic, osteoblastic, or mixed response in bone. Metastasis from different types of malignancies can produce predominantly blastic, lytic or mixed bone metastases [Table 11.2]. Prostate and breast primarily cause the majority of the bone metastases, that is, up to 70 per cent [16].
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Published in Valerio Voliani, Nanomaterials and Neoplasms, 2021
Thomas J. Anchordoquy, Yechezkel Barenholz, Diana Boraschi, Michael Chorny, Paolo Decuzzi, Marina A. Dobrovolskaia, Z. Shadi Farhangrazi, Dorothy Farrell, Alberto Gabizon, Hamidreza Ghandehari, Biana Godin, Ninh M. La-Beck, Julia Ljubimova, S. Moein Moghimi, Len Pagliaro, Ji-Ho Park, Dan Peer, Erkki Ruoslahti, Natalie J. Serkova, Dmitri Simberg
Metastatic tumor cells present a great challenge because they are sequestered next to the blood vessels in the bone marrow and other organs [24] and often become refractory and resistant to therapy. The ability of nanomedicine to cross that barrier and either to enhance the dormancy or to destroy the dormant cells is key to achieving an antimetastatic effect. There was an opinion that unleashing the immune system may be an optimal way to target tumor metastases, and the delivery of specific immunostimulatory signals to the immune cells may be a promising approach. In that regard, the strategy for targeted delivery of payload to a variety of circulating lymphocytes (e.g., cytotoxic and regulatory T-lymphocytes, chimeric antigen receptor T-lymphocytes, natural killer cells, neutrophils, and monocytes) in order to boost antimetastatic response/immunity, possibly as an adjuvant to immunotherapy, could be an exciting perspective for nanotherapy. At the same time, the science of delivery into the heterogeneous population of blood cells remains a challenge. Seemingly, systemic drug delivery to leukocytes should be less challenging in comparison to solid tumors, as there are fewer barriers to cross. However, due to the fact that leukocytes are notoriously hard to transfect and are spread not only in peripheral blood but also in the bone marrow, lymph nodes, lymphatic organs, and other organs, there is an unmet need for developing designated delivery strategies to leukocytes [25].
Estimation of Growth and Metastatic Rates of Primary Breast Cancer
Published in Ovide Arino, David E. Axelrod, Marek Kimmel, Mathematical population dynamics, 2020
John P. Klein, Robert Bartoszyński
Finally, assumption 5 accounts for the fact that patients are followed more carefully after initial treatment of the primary, so that the detection rates for metastasis are higher than those for the primary. Metastases may be detected by a variety of methods, including visual examination, bone scans, biochemical analysis, or by non-cancer-specific symptoms indicating damage or malfunction of an organ, leading to diagnosis through additional testing. The likelihood of detecting a metastasis by these methods is assumed to be an increasing function of the number of cancer cells, whether the metastasis is localized to a measurable mass or spread throughout an organ.
An update on locoregional percutaneous treatment technologies in colorectal cancer liver metastatic disease
Published in Expert Review of Medical Devices, 2023
Stavros Spiliopoulos, Ornella Moschovaki-Zeiger, Akshay Sethi, George Festas, Lazaros Reppas, Dimitris Filippiadis, Nikolaos Kelekis
Due to the pathophysiology of CLC, about half of the patients present with concomitant liver or other organ metastases at the time of diagnosis and the majority of these lesions are deemed not amenable for surgical resection [5]. The development of image-guided, interventional radiology techniques offer locoregional tumor control via percutaneous and endovascular means, without the need for surgery and therefore could play a significant role in the patients’ quality of life and overall survival. The liver is the most common site of metastases, with an approximately 20% incidence of synchronous metastases present at the time of diagnosis. This percentage is elevating during the course of the disease depending on histological subtype, location and stage of the disease [6,7]. While surgical resection remains the gold standard curative option with 5-year survival rates as high as 58%, unfortunately, only 20% of the patients are considered surgical candidates at the time of diagnosis [8,9]. Criteria for inoperability include severe comorbidities, poor performance status, extent of liver disease (number of liver metastases, absence of future liver remnant and liver function) and unfavorable location of metastases (mainly close proximity to important structures) [10].
Optimal control problem for cancer invasion parabolic system with nonlinear diffusion
Published in Optimization, 2018
P. T. Sowndarrajan, L. Shangerganesh
Cancer is a class of disease that becomes one of the leading causes of mortality in the human endeavours. It is a result of the uncontrollable growth of cells and can invade surrounding healthy tissues. It also spreads to other parts of the body. Cancer cells continuously involve in cell division and irregulate the functions of organs by forming lumps or mass of the abnormal cells. It is called a tumour. The cells of benign or non-cancerous cells do not spread elsewhere in the body, whereas the cells of cancer are dependent on the diffusion. Metastasis is the process of spreading and formation of secondary tumours. It is the main cause of death in cancer patients. Therefore, understanding the mechanism of cancer progression is necessary for its diagnosis and treatment. In the literature, many researchers have developed mathematical models to understand and predict how cancer cells evolve and respond to therapy, for example, see [1–5] and the references therein.
Drug-eluting implants for the suppression of metastatic bone disease: current insights
Published in Expert Review of Medical Devices, 2018
Ippokratis Pountos, Peter V. Giannoudis
Bone is the third most common site of metastases after the lung and the liver. Bone metastases can be found in up to 70% of the cases, especially with disease progression [1]. Despite the fact that bone metastases have been reported with all types of cancer, bone microenvironment favors particular types, with breast and prostate to be the most common primary cancer origins. Following colonization and homing of cancer cells in the bone, cancer cells can cause a significant imbalance of bone remodeling with unregulated resorption or formation [1-6]. This is mainly triggered by the release of molecules by tumor cells that increase the osteoclastic activity and/or minimizing the function of the osteoblasts resulting in the destruction of the bone [1–6]. These molecules are presented in Figure 1 [1–6]. Clinically this imbalance is seen as osteolytic lesions or osteosclerosis, each characterizing specific cancer types. This alteration of bone microenvironment could lead to bone fragility and microfractures [1,2]. Microfractures and impeding fractures can be a significant cause of pain and disability, which, with further progression of the disease, can lead to a complete fracture. A fracture is a strong negative prognostic factor known to decrease the autonomy, quality of life, and overall survival of the patient [7]. Such patients require longer hospitalization, stronger analgesia and their rehabilitation is slow and challenging [7]. In addition, interruption of the chemotherapy is often required and the risk of infection is significantly high.