Boney metastasis may lead to terrible suffering from debilitating pain.
The most likely malignancies that spread to bone are prostate, breast, and lung. Painful osseous metastases are typically associated with multiple episodes of breakthrough pain which may occur with activities of daily living, weight bearing, lifting, coughing, and sneezing. Almost half of these breakthrough pain episodes are rapid in onset and short in duration and 44% of episodes are unpredictable. Treatment strategies include: analgesic approaches with "triple opioid therapy", bisphosphonates, chemotherapeutic agents, hormonal therapy, interventional and surgical approaches, steroids, radiation (external beam radiation, radiopharmaceuticals), ablative techniques (radiofrequency ablation, cryoablation), and intrathecal analgesics.
Written by:
Smith HS, Mohsin I. Are you the author?
Department of Anesthesiology, Albany Medical College, Albany, New York, USA.
Reference: Korean J Pain. 2013 Jul;26(3):223-41.
doi: 10.3344/kjp.2013.26.3.223
PubMed Abstract
PMID: 23861996
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