Bone metastasis. Prognosis, diagnosis and treatment.

Carcinoma of the breast, lung or prostate cause the majority of all bone metastases. Prolonged survival is common in patients with breast or prostate tumours. Different types of treatment may significantly increase the quality of life. Single-dose or fractionated radiation therapy may be effective, and 70 to 90 per cent of patients obtain partial or complete relief from pain. Surgery followed by irradiation is indicated in most patients with pathologic femur fractures. Immediate surgical treatment, either alone or combined with radiation therapy, may prevent paraparesis in patients with incipient cord compression. For neoplasms sensitive to systemic therapy such treatment should often be added to local treatment.