Modern Palliative Treatments for Metastatic Bone Disease: Awareness of Advantages, Disadvantages and Guidance.

Metastatic disease is the most common malignancy of bone. Prostate, breast, lung, kidney and thyroid cancer account for 80% of skeletal metastases. Bone metastases are associated with significant skeletal morbidity including severe bone pain, pathological fractures, spinal cord or nerve roots compression, and malignant hypercalcemia. These events compromise greatly the quality of life of the patients. The treatment of cancer patients with bone metastases is mostly aimed at palliation. Currently, modern treatments are available for the palliative management of patients with metastatic bone disease. These include modern radiation therapy, chemotherapy, embolization, electrochemotherapy, radiofrequency ablation, and high intensity focused ultrasound. This article aims to present these palliative treatments for the patients with bone metastases, summarize the clinical applications, and review the techniques and results. It gives an extensive overview of the possibilities of palliation in patients with metastatic cancer to bone. As such it is of interest for all physicians with no experience with these developments to make palliative procedures safer and more reliable.