Bone health is often compromised in patients with cancer because of the disease itself or the chemotherapeutics. The European Society for Medical Oncology (ESMO) provides information guideline for physicians regarding pathology, etiology, diagnosis, and treatment for bone disorders in cancer patients. Pathophysiology of bone metastasis: The process of cancer metastasis includes: tumor cell seeding tumor dormancy subsequent metastatic growth The guideline gives detailed pathway of bone metastasis. Briefly, the circulating breast and prostate cancer cells have a particular affinity for bone.
Bone marrow microenvironment may act as a reservoir for malignant cells. These cells may remain dormant and relapse years later after diagnosis. The tumor cells release growth factors that activate osteoclasts and disturb the balance of bone formation and reabsorption. The growth factors from broken…
