Clinical Chemistry
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Clinical Chemistry 45: 1131-1132, 1999;
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(Clinical Chemistry. 1999;45:1131-1132.)
© 1999 American Association for Clinical Chemistry, Inc.

Editorials

Biochemical Markers in the Management of Patients with Metastatic Bone Disease

Laurence M. Demers

The Pennsylvania State University, College of Medicine, Hershey, PA 17033

Patients with cancer usually die not as a result of their primary malignancy but of the metastatic disease process that ultimately develops. One-third of cancer patients will have metastases of their primary tumor to bone (1). The metastatic spread of cancer to bone is common to many different malignancies, particularly breast (73%), prostate (68%), and lung (36%) cancers (2). Bone metastases, in fact, account for the highest proportion of first sites of relapse in breast cancer patients. Metastases to bone cause accelerated bone resorption both from direct effects of the tumor itself and through the activation of osteoclast cells in bone via humoral and growth factors such as cytokines, platelet-derived growth factor, and parathyroid hormone-related protein (3). For most cancer patients, treatment of advanced metastatic disease is usually palliative, with quality of life a primary goal of therapy. Although patients will develop visceral as well as bony metastases, in many cases metastasis is exclusively to bone. There are numerous clinical consequences of metastatic bone disease, including hypercalcemia, bone pain, pathological fractures, and spinal cord compression. In many of these patients, appropriate therapy can resolve the hypercalcemia, improve the bone pain, and ward off the development of pathological fractures that compromise the mobility and quality of life . . . [Full Text of this Article]


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 Clin. Chem.Home page
R. L. Fitzgerald, D. J. Hillegonds, D. W. Burton, T. L. Griffin, S. Mullaney, J. S. Vogel, L. J. Deftos, and D. A. Herold
41Ca and Accelerator Mass Spectrometry to Monitor Calcium Metabolism in End Stage Renal Disease Patients
Clin. Chem., November 1, 2005; 51(11): 2095 - 2102.
[Abstract] [Full Text] [PDF]


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