Most common cause of bone malignancy
Metastatic bone disease is the most commonest malignancy of bones and is much more than primary bone tumors Metastatic Bone Diseases(MBD) Cancer that begins in an organ, such as the lungs. breast, or prostate, and then spreads to bone is called metastatic bone disease (MBD). More than 1.2 million new cancer cases are diagnosed each year. Approximately 50% of these tumours can spread (metastasize) to the skeleton. With improved medical treatment of many cancers --especially breast. lung, and prostate -- patients are living longer. However, the primary cancers in more of these patients are spreading to bone. The tumours that result are called bone metastases. Organs involved in MBD * The most common cancers that arise from organs and spread to bone include: * Breast * Lung * Thyroid * Kidney * Prostate Pathophysiology of MBD : MBD causes pain in the area of spread. damages and weakens bone, and puts the patient at a greater risk for broken bones. It can make it hard to paicipate in daily activities. The biggest concern for patients with MBD is the general loss in quality of life. How much of an effect MBD has on a patient will vary and is associated with how much the cancer has spread. which bones are affected, and how severe the bone damage is. There are a range of treatment options, however. that can help patients manage pain and maintain their independence and activity levels. After the lung and the liver, the skeleton is the most common site of spread of cancers that begin in organs. Metastases to the lung and liver are often not detected until late in the course of disease because patients experience no symptoms. In contrast. bone metastases are generally painful when they occur. Cancer most commonly spreads to these sites in the skeleton: Spine Pelvis Ribs Skull Upper arm Symptoms Pain. The most common symptom of MBD is pain. Patients may have pain in the spine, pelvis, or extremities because the bone has been weakened by the tumour. Fractures. Weakened bones break more easily. A fracture from a minor injury is another possible sign of MBD. Anaemia. The most common sites of spread -- spine, pelvis, ribs, skull, upper arm, and long bones of the leg --correspond to areas of bone marrow that produce high levels of red blood cells, the cells responsible for carrying oxygen to tissues in the body. Anaemia (decreased red blood cell production) is a common blood abnormality in patients with MBD. A cancer patient who experiences any pain, especially in the back, legs, and arms, should notify his or her doctor immediately. Pain that occurs without activity (i.e., walking or lifting an object) is paicularly concerning. Refer Apleys 9th/e p 216
Secondaries
Osteosarcoma
Ewings sarcoma
Osteoclastoma