Abstract
Metastatic spread to the skeletal system is a leading cause of morbidity and mortality in patients with cancer. With improved diagnostic imaging, laboratory studies, and new treatments, life expectancy has improved in oncology patients. With this increase in survival, the overall healthcare burden of metastatic bone disease also has increased. Treatment of metastatic disease of bone should be multidisciplinary and provide local and systemic tumor control. The overall performance status of a patient, the presence or absence of multiple lesions, the anatomic site affected, and viscera involved will all influence surgical options. If a pathologic fracture or impending fracture is present, the treatment should be durable and expected to last for the life of the patient. This review summarizes current concepts in the diagnosis and management of metastatic bone cancer, including the clinical approach to new bone lesions in patients without a known primary carcinoma, as the origin of such tumors has a significant implication on skeletal events and overall prognoses.
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