Bisphosphonates: clinical experience.

Bone is a preferred site of metastasis for many solid tumors, and the complications associated with bone metastases can result in significant skeletal morbidity including severe bone pain, pathologic fracture, spinal cord compression, and hypercalcemia of malignancy (HCM). Bisphosphonates are the current standard of care for preventing skeletal complications associated with bone metastases. Clinical trials investigating the benefit of bisphosphonate therapy have used a composite end point defined as a skeletal-related event (SRE) or bone event, which typically includes pathologic fracture, spinal cord compression, radiation or surgery to bone, and HCM.

Essential oncology facts for the float nurse.

Hospitals are faced with the challenge of staffing oncology units with nurses who do not routinely work with cancer patients. The Essential Oncology Facts Guide can be used to provide critical information that is specific to each oncology unit and to care of the cancer patient.

Radioisotopes for metastatic bone pain.

Background: Bone metastases manifest through pain, which can arise even before the injury is radiologically detected. Pain occurs as a result of bone destruction and, as more destruction ensues, more pain can be experienced. Radiculopathies, plexopathies and shrinkage of spinal nerves due to tumour growth and fractures are very frequent in these patients.

Rehabilitation of a child with a spinal cord injury.

The incidence and sex distribution of spinal cord injury (SCI) changes with age. Motor vehicle accidents, bicycle accidents, sports accidents, and violence are major causes in the pediatric population. Pulmonary complications may be severe and life-threatening in the acute phase.

[Bone metastasis in patients with breast cancer].

Breast cancer (BC) is quite often accompanied by affection of the bones and alterations in mineral metabolism. The most important clinical manifestations of the above processes that appeared to a considerable extent to be a cause of a poor condition of patients include pains in bones, pathological fracture and hypercalcemia. Metastatic events in the skeleton bone are recordable in 13.

Efficacy of bisphosphonates in the management of skeletal complications of bone metastases and selection of clinical endpoints.

Bisphosphonates are the current standard of palliative care for patients with bone lesions from breast cancer and multiple myeloma. This article discusses the selection of endpoints and statistical methods used to assess clinical efficacy of bisphosphonate therapies in patients with bone metastases. Recent studies of pamidronate and zoledronic acid have set the standards for the design and conduct of multicenter, randomized, placebo-controlled trials to assess the clinical benefit of bisphosphonates in patients with bone metastases.

Effects of long-term intravenous ibandronate therapy on skeletal-related events, survival, and bone resorption markers in patients with advanced multiple myeloma.

Purpose: Bisphosphonates have been found to reduce the incidence of skeletal-related events (SREs) in patients with multiple myeloma. This is the first double-blind, randomized, placebo-controlled study to assess the efficacy of ibandronate, a third-generation amino-bisphosphonate, in preventing SREs in advanced-stage multiple myeloma patients.

Patients And Methods: Patients with multiple myeloma stage II or III were randomly assigned to receive either ibandronate 2 mg or placebo as a monthly intravenous (IV) bolus injection for 12 to 24 months in addition to conventional chemotherapy.

Oncologic emergencies for the internist.

Most cancer patients experience at least one emergency during the course of the disease. This paper reviews the diagnosis and treatment of tumor lysis syndrome, hypercalcemia of malignancy, superior vena cava syndrome, spinal cord compression, strokes and seizures, and treatment-related emergencies.

Osteoporosis in women with spinal cord injuries.

Decreased bone density and increased fracture risk are seen in patients with SCI. The bone resorption rate is markedly increased. Hypercalciuria, low PTH, and low 1,25 (OH)2 vitamin D are commonly seen.

Analysis of skeletal-related events in breast cancer and response to therapy.

The skeleton is a common site for the spread of metastatic cancer and skeletal complications are a cause of significant morbidity and mortality. Treatment of skeletal morbidity is therefore an essential component of therapy for cancer patients with bone metastases. Bisphosphonates are currently the treatment of choice for skeletal complications.

Metastatic bone disease: clinical features, pathophysiology and treatment strategies.

Metastatic bone disease develops as a result of the many interactions between tumour cells and bone cells. This leads to disruption of normal bone metabolism, with the increased osteoclast activity seen in most, if not all, tumour types providing a rational target for treatment. The clinical course of metastatic bone disease in multiple myeloma, breast and prostate cancers is relatively long, with patients experiencing sequential skeletal complications over a period of several years.

Predictors of skeletal complications in patients with metastatic breast carcinoma.

Background: The high rate of incidence of skeletal complications in women with metastatic breast carcinoma appears to contribute significantly to their morbidity. Although recent trials have demonstrated the efficacy of bisphosphonates in preventing skeletal complications in selected patients, to the authors' knowledge the incidence rate of skeletal complications in an unselected population of women with metastatic breast carcinoma is unknown. The current study was designed to examine the incidence rate of skeletal complications in a large unselected group of women with metastatic breast carcinoma to determine predictors of these complications.

Orthopedic emergencies in cancer patients.

The most frequent orthopedic emergency in oncology patients is fracture. Stabilization of the entire fractured bone restores function and relieves pain. The site, quality, and extent of the lesion can identify impending fractures that should be stabilized.

[Biosphonates in oncology].

Mechanism Of Action: Tumor-induced osteolysis or lytic bone disease is mediated by osteoclast activation. Bisphosphonates inhibit bone resorption by reducing osteoclastic activity.

Indications: Bisphosphonates were shown to be effective in treating cancer-related hypercalcemia.

Immobilization hypercalcemia treatment with pamidronate disodium after spinal cord injury.

Objective: To review the use of pamidronate to treat immobilization hypercalcemia after acute spinal cord injury (SCI) in 9 cases.

Design: Retrospective case series.

Setting: Two inpatient rehabilitation programs, one pediatric and one adult, in the Northwest Regional Spinal Cord Injury System.

Skeletal complications of malignancy.

The skeleton is the most common organ to be affected by metastatic cancer, and tumors arising from the breast, prostate, thyroid, lung, and kidney possess a special propensity to spread to bone. Breast carcinoma, the most prevalent malignancy, causes the greatest morbidity. Of great clinical importance is the observation that metastatic bone disease may remain confined to the skeleton.