Managing metastatic bone pain: New perspectives, different solutions

Iwona Zaporowska-Stachowiak; Jacek Łuczak; Karolina Hoffmann; Katarzyna Stachowiak; Wiesław Bryl; Maciej Sopata

doi:10.1016/j.biopha.2017.07.023

Managing metastatic bone pain: New perspectives, different solutions

Biomed Pharmacother. 2017 Sep:93:1277-1284. doi: 10.1016/j.biopha.2017.07.023. Epub 2017 Jul 21.

Authors

Iwona Zaporowska-Stachowiak¹, Jacek Łuczak², Karolina Hoffmann³, Katarzyna Stachowiak⁴, Wiesław Bryl⁵, Maciej Sopata²

Affiliations

¹ Chair and Department of Pharmacology, Poznań University of Medical Sciences, Poland; Palliative Medicine In-Patient Unit, University Hospital of Lord's Transfiguration, Poznań University of Medical Sciences, Poland. Electronic address: iwozapor@ump.edu.pl.
² Palliative Medicine In-Patient Unit, University Hospital of Lord's Transfiguration, Poznań University of Medical Sciences, Poland; Department of Palliative Medicine, Poznań University of Medical Sciences, Poland.
³ Arterial Hypertension and Metabolic Disorders In-patient Unit, University Hospital of Lord's Transfiguration, Poznań University of Medical Sciences, Poland.
⁴ Institute of Applied Linguistics, University of Warsaw, Poland.
⁵ Arterial Hypertension and Metabolic Disorders In-patient Unit, University Hospital of Lord's Transfiguration, Poznań University of Medical Sciences, Poland; Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences, Poland.

PMID: 28747002
DOI: 10.1016/j.biopha.2017.07.023

Abstract

Bone metastases are the most frequent cause of cancer-induced bone pain (CIBP). Although palliative radiotherapy and pharmacotherapy conducted according to World Health Organization (WHO) analgesic ladder are the treatment of choice for CIBP reduction, these methods are not always successful, especially with regard to alleviation of incidental pain. Antiresorptive drugs (bisphosphonates) are able to inhibit bone destruction (loss), proliferation of cancer cells and angiogenesis, but their prolonged use may lead to a spectrum of adverse effects. In this paper, types of bone metastases, their complications, as well as diagnostic and therapeutic implications are presented. Moreover, the paper discusses presently used CIBP treatment methods and research directions for future methods, with special focus on bone metastases.

Keywords: Antiresorptive drugs; Bone metastases; Bone pain; Pathological fractures; Spinal cord compression.

Publication types

Review

MeSH terms

Bone Density Conservation Agents / therapeutic use*
Bone Neoplasms / complications*
Bone Neoplasms / pathology
Cancer Pain / drug therapy*
Diphosphonates / therapeutic use*
Humans
Neoplasm Metastasis / pathology

Substances

Bone Density Conservation Agents
Diphosphonates