T&O: Metastatic Bone Disease Flashcards
Outline the pathophysiology of Metastatic Bone Disease
Cancer spreads from a primary organ site to bone
The spine is the most common location of metastatic disease
Cellular events = attachment of tumour cells to the basement membrane, the production of proteolytic enzymes, migration of tumour cells through the basement membranes into surrounding tissue
Outline the aetiology of Metastatic Bone Disease.
Most common site F = breast, lung
Most common site M = prostate, lung
Other = thyroid, kidney
What are the symptoms of Metastatic Bone Disease?
Bone pain present at night and rest
Broken bones
Urinary incontinence
Bowel incontinence
Weakness in the legs or arms
Hypercalcemia = nausea, vomiting, constipation and confusion
How would you investigate Metastatic Bone Disease?
Serum alkaline phosphatase = indirect reflection of bone destruction
Serum protein electrophoresis
Urinalysis, urine protein electrophoresis
X-ray
CT
MRI
Bone scanning
Angiography
Biopsy = percutaneous core needle, open
How would you manage Metastatic Bone Disease?
Radiotherapy
Surgery = can help stabilize a bone that is at risk of breaking or repair a broken bone
Chemotherapy
Pharmacotherapy = monoclonal antibodies, Ca metabolism modifiers/bisphosphonates
Pain medication
Steroids
What are the complications of Metastatic Bone Disease?
Cancer-induced bone pain
Hypercalcemia
Pathological bone fractures
Metastatic epidural spinal cord compression
Cancer cachexia = extreme weight loss, anorexia, muscle wasting, and fatigue
