Managing metastatic bone pain: New perspectives, different solutions

Zaporowska-Stachowiak, Iwona; Łuczak, Jacek; Hoffmann, Karolina; Stachowiak, Katarzyna; Bryl, Wiesław; Sopata, Maciej

doi:10.1016/j.biopha.2017.07.023

Cited by 21 publications

(13 citation statements)

References 84 publications

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“…This balance is disturbed in neoplastic bone transformation [13,24]. At radiological and histopathological levels, bone metastases can be classified as osteolytic, osteosclerotic, or mixed [35]. Typically, osteolytic lesions are caused by breast cancer and multiple myeloma.…”

Section: Mechanisms Of Bone Pain In Cancer Patientsmentioning

confidence: 99%

Bone Pain in Cancer Patients: Mechanisms and Current Treatment

Zajączkowska

Kocot-Kępska

Leppert

et al. 2019

IJMS

167

127

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The skeletal system is the third most common site for cancer metastases, surpassed only by the lungs and liver. Many tumors, especially those of the breast, prostate, lungs, and kidneys, have a strong predilection to metastasize to bone, which causes pain, hypercalcemia, pathological skeletal fractures, compression of the spinal cord or other nervous structures, decreased mobility, and increased mortality. Metastatic cancer-induced bone pain (CIBP) is a type of chronic pain with unique and complex pathophysiology characterized by nociceptive and neuropathic components. Its treatment should be multimodal (pharmacological and non-pharmacological), including causal anticancer and symptomatic analgesic treatment to improve quality of life (QoL). The aim of this paper is to discuss the mechanisms involved in the occurrence and persistence of cancer-associated bone pain and to review the treatment methods recommended by experts in clinical practice. The final part of the paper reviews experimental therapeutic methods that are currently being studied and that may improve the efficacy of bone pain treatment in cancer patients in the future.

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Section: Mechanisms Of Bone Pain In Cancer Patientsmentioning

confidence: 99%

Bone Pain in Cancer Patients: Mechanisms and Current Treatment

Zajączkowska

Kocot-Kępska

Leppert

et al. 2019

IJMS

167

127

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“…Unlike bone metastasis that usually cause severe notable pain in PCa patients, 6 liver metastasis is often symptomless at the beginning. Thus, when liver metastasis is clinically detected, many patients have reached the end stage of their disease.…”

Section: Introductionmentioning

confidence: 99%

A novel mouse model for liver metastasis of prostate cancer reveals dynamic tumour‐immune cell communication

et al. 2021

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“…Several possible mechanisms have been reported. 4 However, the exact mechanism remains unclear. Therefore, some patients may be refractory to pharmacological treatment according to the three-step analgesic ladder established by the World Health Organization.…”

Section: Discussionmentioning

confidence: 99%

“…Radical decompression was carried out along left L5 nerve pathway until the outer aspect of the L5/S1 intervertebral foramina was reached. L4 and S1 were fixed with screws through their left pedicles ( Figures 3,4). No bone grafting was performed considering the patient's short life expectancy.…”

Section: Case Presentationmentioning

confidence: 99%

Integrated approach to pain management for a patient with multiple bone metastases of uterine cervical cancer

Qin

Song

et al. 2018

J Int Med Res

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BackgroundPain management for multiple bone metastases is complex and often requires multidisciplinary treatment. We herein describe patient-centered multidisciplinary pain management for metastatic cancer.Case presentation: A 61-year-old woman with multiple bone metastases of uterine cervical cancer developed intractable low back pain. After external beam radiotherapy failed, we performed lumbar spinal intralesional curettage, pedicle screw fixation, and nerve decompression. However, the neuralgia persisted. We then percutaneously injected epirubicin into the intervertebral foramina under computed tomography guidance for L5 dorsal root ganglion destruction. Osteoplasty was performed under C-arm X-ray guidance; however, the sacrum was mistaken for the ilium, and treatment was ineffective. We administered zoledronic acid and strontium-89. The last resort was outpatient implantation of an epidural bupivacaine-morphine infusion system. A visual analog scale (VAS) was used for pain evaluation. Lumbar spinal intralesional curettage and fixation, epirubicin-induced ganglion destruction, and administration of zoledronic acid and strontium-89 decreased her VAS pain score from 7–8 to 3–4. Radiotherapy and nerve decompression and release were ineffective, as was osteoplasty because of the location error. The epidural infusion system decreased the VAS score from 7–8 to 2–3 and was highly efficient.ConclusionsMultidisciplinary integrated treatment for metastatic cancer can be effective.

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Managing metastatic bone pain: New perspectives, different solutions

Cited by 21 publications

References 84 publications

Bone Pain in Cancer Patients: Mechanisms and Current Treatment

Bone Pain in Cancer Patients: Mechanisms and Current Treatment

A novel mouse model for liver metastasis of prostate cancer reveals dynamic tumour‐immune cell communication

Integrated approach to pain management for a patient with multiple bone metastases of uterine cervical cancer

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