Iris Publishers-Open access Journals of Urology & Nephrology | Specific Treatment of Bone Metastases in Non-PC Urological Malignancies

Authored by Aleksandar Vuksanovic

Bones are common site for metastatic development, in fact the third most common site of metastases, right after lungs and liver. This tendency is explained with its microenvironment – specifically bone marrow, that tends to facilitate “thriving” of certain types of metastatic cancer cells, which usually originate from prostate, breast and lung. Prostate cancer in particular has proclivity for development of osseous metastases, where we commonly find that the bones are the only site of its secondary deposits [1].
Bone metastases carry a risk for developing of skeletal related events (SRE), which include: bone fractures (radiological or clinical), need for radiotherapeutical or surgical management, spinal cord compression, hypercalcemia [2]. SREs have detrimental effect on patients, reducing quality of life, mobility, life expectancy, and vastly increase medical expenditures.
Specific treatment of bone metastases has several goals: reduction or complete removal of pain, movement amelioration, increase of survival and prevention of SREs. These can be achieved with different approaches and therapeutic options – locally (surgery, radiotherapy), systemically (bisphosphonates, RANKL inhibitor, radionuclides...), and symptomatically.
In majority of urological publications about bone metastases, focus is usually on prostate cancer [3], which is justifiable due to its impact. Nevertheless, practically all urological tumors can disseminate to the bones, and in some cancers they frequently do so. In this article, we will try to review therapeutic options for urological patients, suffering from the bone metastases, excluding prostate cancer.

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