Breast cancer
Pat Price, Karol Sikora in Treatment of Cancer, 2014
Bone is the most common site of metastases, and approximately 70% of patients dying from metastatic breast cancer have evidence of bone metastases at post-mortem analysis.150 Skeletal complications from bony metastases also referred to as skeletal related events (SREs) are responsible for major morbidity and include hypercalcaemia, pathologic fracture, spinal cord compression (Figure 6.9) and the need for radiotherapy treatment or surgery to bone. Bone metastases are the common cause of cancer-related pain affecting the patient’s quality of life, but bone pain is not included in the definition of SREs and is instead measured as a separate outcome in clinical trials. Management options for bone metastases include systemic therapies (chemotherapy, endocrine therapy and targeted therapies), local therapies (radiotherapy and surgery) and bone-targeting agents (osteoclast inhibition) that reduce SREs such as denosumab and bisphosphonates.
Breast Cancer
Pat Price, Karol Sikora in Treatment of Cancer, 2020
Bone is the most common site of metastases, and approximately 70% of patients dying from metastatic breast cancer have evidence of bone metastases at post-mortem analysis.187 Skeletal complications from bony metastases also referred to as skeletal-related events (SREs) are responsible for major morbidity and include hypercalcemia, pathologic fracture, spinal cord compression (Figure 6.9), and the need for radiotherapy treatment or surgery to bone. Bone metastases are the common cause of cancer-related pain affecting the patient’s quality of life, but bone pain is not included in the definition of SREs and is instead measured as a separate outcome in clinical trials. Management options for bone metastases include systemic therapies (chemotherapy, endocrine therapy, and targeted therapies), local therapies (radiotherapy and surgery), and bone-targeting agents (osteoclast inhibition) that reduce SREs such as denosumab and bisphosphonates.
Radionuclide imaging of carcinoid tumors, neurendocrine tumors of the pancreas and adrenals
Demetrius Pertsemlidis, William B. Inabnet III, Michel Gagner in Endocrine Surgery, 2017
The presence of bone metastases is associated with a poor prognosis [92]; thus, different treatment strategies may be preferred over surgical intervention. In 51 NET patients with no evidence of bone metastases on conventional bone scintigraphy, 18F-Na-fluoride PET, or CT, 68Ga-DOTATOC PET proved to be a superior modality in the detection of bone metastases, with a sensitivity of 97% and a specificity of 92% [91]. Moreover, 68Ga-DOTATOC PET detected bone metastases at a significantly higher rate than did CT [69, 91] (p ≤ 0.001). These results lent further credence to the use of 68Ga-DOTATOC PET as a reliable first-line imaging test at staging or restaging of NET patients. On a lesion-based analysis in 18 patients, Wild et al. reported a higher detection rate of bone lesions with 68Ga-DOTATATE compared with 68Ga-DOTANOC (89% vs. 82%) because of a lower bone marrow activity with 68Ga-DOTATATE, resulting in a higher tumor-to-background activity and a high detection rate of bone metastases [70]. These results lent further credence to the use of 68Ga-DOTATOC PET as a reliable first-line imaging test at staging or restaging of NET patients.
Cost-effectiveness of denosumab for the prevention of skeletal-related events in patients with solid tumors and bone metastases in the United States
Published in Journal of Medical Economics, 2020
Alison Stopeck, Adam Brufsky, Lisa Kennedy, Sumi Bhatta, Debajyoti Bhowmik, Jacqueline Buchanan, Nicolas Despiegel, Guy Hechmati
Bone is a common site of metastatic disease for a variety of solid tumors, with bone metastases occurring in up to 75% of patients with advanced metastatic breast and prostate cancers1,2. Patients with solid tumors and bone metastases are at an increased risk for bone complications (also known as skeletal-related events [SREs]): rates of bone complications are ∼40% (19 months) in patients with prostate cancer and 54% (24 months) in patients with breast cancer3,4. Bone complications are associated with decreased survival and considerable morbidity, pain, impaired mobility, and decreased quality-of-life3,5–10. Healthcare costs for patients with bone complications are substantial3,11–16.
Practicality of using the figure-of-eight bandage to prevent fatal wound dehiscence after spinal tumor surgery for upper thoracic metastasis
Published in British Journal of Neurosurgery, 2018
Dong Kwang Seo, Jin-Hoon Park, Sun Kyu Oh, Yongchel Ahn, Sang Ryong Jeon
Bone metastases frequently develop from malignant tumors, with the spine being the most common site.1 About 10% of cancer patients develop spinal metastases,2 and most are found in the thoracic region, particularly at the T4–7 level.3 There are various treatment modalities, including radiotherapy (RT), radiosurgery, and surgical treatment. Among these, decompressive surgery and instrumentation of the area around the lesion combined with RT are considered the standard treatment options for metastatic spinal disease.4 Although this standard treatment is effective for metastatic spinal cord compression (MSCC), great concerns regarding wound problems caused by RT during the perioperative period remain unsolved.5–11 These issues include more frequent wound dehiscence in the upper thoracic region due to increased tension caused by shoulder movement.12 Furthermore, in our experience, most wound dehiscence appears in the upper thoracic region. We hypothesized that the figure-of-eight bandage, which is widely used to conservatively treat clavicle fractures by securely fixing shoulder movement,13 would prevent excessive shoulder motion and avert wound dehiscence in the upper thoracic region. Accordingly, we applied this brace immediately during the postoperative period to patients with upper thoracic MSCC. We describe the efficacy of using the figure-of-eight bandage to prevent postoperative wound dehiscence in the upper thoracic region in MSCC patients who have undergone decompression and fixation surgery with perioperative RT and/or chemotherapy.
Bone-targeted agent treatment patterns and the impact of bone metastases on patients with advanced breast cancer in the United States
Published in Current Medical Research and Opinion, 2019
David Henry, Roger von Moos, Jean-Jacques Body, Alex Rider, Jonathan De Courcy, Debajyoti Bhowmik, Francesca Gatta, Guy Hechmati, Yi Qian
Patient demographics and clinical characteristics included time from initial breast cancer diagnosis to bone metastasis diagnosis, time from bone metastasis diagnosis to survey completion date, menopausal status, and family history of breast or ovarian cancer. The presence of bone pain was indicated at the initial diagnosis of bone metastasis and at survey completion. The grade of bone pain, indicated as mild, moderate or severe, was measured using the Brief Pain Inventory (BPI), a validated instrument used to assess pain intensity and interference with daily activities26. The range of BPI worst pain was from 0 (no pain) to 10 (worst pain), with ratings from 1 to 4 corresponding with mild pain, 5 to 6 with moderate pain and 7 to 10 with severe pain. Use of analgesics, including weak or strong opioids, was also evaluated using the Analgesic Quantification Algorithm27.
Related Knowledge Centers
- Bone
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- Metastasis
- Cancer
- Primary Tumor
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- Osteolytic Lesion
- Tumors of The Hematopoietic & Lymphoid Tissues