Metastatic disease of skeleton

Bone metastasis is a catastrophic complication for most patients with cancer and can cause significant morbidity to a patient. It stands 3^rd most common site secondary to liver and lungs. Prostate and breast are more common to cause bone metastasis. They can be osteolytic, osteoblastic or a combination of both. Vertebrae are commonly involved (50-70%). Proximal femur, ribs, sternum, pelvis, and skull are other common sites. Only 10% of patients get symptoms. Pain, pathological fractures, spinal cord compression syndromes and hypercalcaemia are common presentations. Precise mechanism of metastasis is not understood. Establishment of skeletal metastasis involves interactions between the tumor cell and the cellular elements in the bone microenvironment. Majority of patients need non operative conservative treatment. Principles of treatment include control of local symptoms; maintain function and mobility and prevention of pathological fractures.