Metastatic disease (MSK) Flashcards
What are the most common causes of bone metastases? (3)
- breast cancer
- lung cancer
- prostate cancer
What are the most common sites of bone metastases - from most to least common? (5)
- spine (most common)
- pelvis
- ribs
- skull
- long bones (least common)
What are spine metastases (bone metastases) associated with? (3)
- back pain worse when sneezing/coughing
- worse at night
- associated with tenderness
What are the clinical features of bone metastases? (4)
- bone pain
- pathological fractures
- hypercalcaemia
- raised ALP
How do we manage bone metastases? (4)
- pain management (radiotherapy)
- chemotherapy
- bisphosphonates for pain (inhibit bone resorption)
- surgery (if pathological fractures or spinal cord compression)
How do you manage neoplastic spinal cord compression while awaiting imaging?
High-dose oral dexamethasone
What are the common causes of brain metastases? (5)
- lung cancer (most common)
- breast cancer
- bowel cancer
- melanoma
- renal cell carcinoma
What are the features of brain metastases? (4)
- seizures
- focal neurological deficits
- cognitive deficits
- headaches
How do we manage brain metastases? (3)
- surgical resection
- stereotactic radiosurgery
- patients with poor functional status may be treated palliatively
What are the most common causes of lung metastases? (6)
- breast cancer
- colorectal cancer
- renal cell carcinoma
- prostate cancer
- bowel cancer
- melanoma
What would a CXR show in lung metastases?
Multiple, round, well-defined lesions = ‘Cannonball metastases’
Most commonly seen with with renal cell cancer - investigate using CT CAP
May also occur secondary to choriocarcinoma and prostate cancer
What are some symptoms of lung metastases? (8)
- SOB
- chest/ribcage pain
- persistent cough
- bloody sputum
- unintended weight loss
- weakness
- Hx of other cancers
- or ASx
How do we manage lung metastases? (2)
- treatment of choice - chemotherapy
- surgery can be effective if: primary cancer controlled, only 1/2 metastases, high probability of success, patient fit enough
