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Metastatic bone pain: treatment options with an emphasis on bisphosphonates


von Moos, R; Strasser, F; Gillessen, S; Zaugg, K (2008). Metastatic bone pain: treatment options with an emphasis on bisphosphonates. Supportive Care in Cancer, 16(10):1105-1115.

Abstract

INTRODUCTION: One of the key targets for metastatic cancer cells is the skeleton. Once metastatic cells are established within the bone matrix, skeletal integrity becomes increasingly compromised. Bone lesions lead to various complications, including bone pain, fractures and spinal cord compression. MECHANISMS OF BONE PAIN: Bone pain is debilitating and affects quality of life of the patient. In addition, it increases the use of health care resources. Many patients with metastatic bone disease experience substantial bone pain despite state-of-the-art systemic analgesic treatment. Incident pain is the predominant pain syndrome. TREATMENT OPTIONS FOR BONE PAIN: Typically, this syndrome requires moderate baseline analgesia with increased on-demand doses. Other techniques for treating bone pain, including radiation therapy, neuraxial application of analgesics, nerve blocks and local stabilisation procedures, should be considered. In addition, therapy with bisphosphonates targeting bone-specific pain is an important strategy. This review discusses the various management options for bone pain arising from metastatic bone disease.

INTRODUCTION: One of the key targets for metastatic cancer cells is the skeleton. Once metastatic cells are established within the bone matrix, skeletal integrity becomes increasingly compromised. Bone lesions lead to various complications, including bone pain, fractures and spinal cord compression. MECHANISMS OF BONE PAIN: Bone pain is debilitating and affects quality of life of the patient. In addition, it increases the use of health care resources. Many patients with metastatic bone disease experience substantial bone pain despite state-of-the-art systemic analgesic treatment. Incident pain is the predominant pain syndrome. TREATMENT OPTIONS FOR BONE PAIN: Typically, this syndrome requires moderate baseline analgesia with increased on-demand doses. Other techniques for treating bone pain, including radiation therapy, neuraxial application of analgesics, nerve blocks and local stabilisation procedures, should be considered. In addition, therapy with bisphosphonates targeting bone-specific pain is an important strategy. This review discusses the various management options for bone pain arising from metastatic bone disease.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Radiation Oncology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2008
Deposited On:09 Jan 2009 12:11
Last Modified:05 Apr 2016 12:45
Publisher:Springer
ISSN:0941-4355
Publisher DOI:10.1007/s00520-008-0487-0
PubMed ID:18682990
Permanent URL: http://doi.org/10.5167/uzh-8968

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