Bone Metastases: Diagnosis and Treatment by R. D. Rubens (auth.), R. D. Rubens BSc, MD, FRCP, I.

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By R. D. Rubens (auth.), R. D. Rubens BSc, MD, FRCP, I. Fogelman BSc, MD, FRCP (eds.)

Bone Metastases brings jointly the numerous fresh advancements which are steadily enhancing the customers for sufferers with secondary involvement of the skeleton in a prime melanoma in other places. The morbidity from bone metastases is vast, and the palliative and supportive therapy that victims require for plenty of months or perhaps years constitutes a massive sickness. A multidisciplinary strategy is key on account that a number of experts are concerned: radiation and scientific oncologists, basic and orthopaedic surgeons, common physicians, radiologists and nuclear medication physicians, symptom keep watch over and terminal care experts. The book's editors, themselves specialists within the fields of oncology and bone sickness respectively, have introduced jointly specialists from most of these disciplines to supply entire assurance of metastatic bone sickness. They conceal the biology and pathophysiology, hypercalcaemia, imaging, evaluate of reaction to remedy, forms of therapy (systemic, radiotherapy, surgery), and symptomatic and supportive care. rather new techniques incorporated are magnetic resonance imaging, the evaluation of skeletal reaction and isotope therapy.

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Extra resources for Bone Metastases: Diagnosis and Treatment

Sample text

The early experience of bone scanning was almost exclusively in patients with known malignancy and, while the role of bone scanning has now expanded to many benign situations, the identification of metastases still remains the most important indication for a bone scan. In this review we shall attempt to define the role of bone scanning in the detection and monitoring of skeletal metastases. Pathophysiology of Skeletal Uptake of Diphosphonate A skeletal radiograph indicates the net result of bone resorption and repair.

In hypercalcaemia of malignancy the bone scan findings may range from normal to extensive metastatic disease. In general the bone scan findings correlate poorly with the degree of hypercalcaemia (Ralston et al. 1982), but this varies from tumour to tumour. In breast cancer, for example, the bone scan findings in hypercalcaemia are typically those of widespread bone metastases and it is uncommon to have a normal bone scan. In carcinoma of the lung this would be a much more common finding explained by the presence of a humoral factor (a parathyroid hormone-like substance) of malignancy which, in addition to altering skeletal metabolism, also has a direct effect on the renal tubules leading to increased reabsorption of calcium (Bourgeois et al.

Invest Urol 17:195-198 Koutsilieris M, Rabbini SA, Bennett HPJ, Goltzman D (1987) Characteristics of prostate-derived growth factors for cells of the osteoblast phenotype. J Clin Invest 80:941-946 Martin TJ, Partridge NC, Greaves M, Atkins D, Ibbotson KJ (1979) Prostaglandin effects on bone and role in cancer hypercalcaemia. In: MacIntyre I, Szelke M (eds) Molecular Endocrinology Elsevier, North-Holland, Amsterdam, pp 251-264 McBride WH (1986) Phenotype and functions of intratumoral macrophages.

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