Metastatic Bone Disease

R. Lor Randall, MD, FACS, The L.B. & Olive S. Young Endowed Chair for Cancer Research Director, Sarcoma Services & Medical Director, HCI Surgical Services Chief, SARC Lab & Fellowships Co-Leader, Sarcoma Disease Oriented Research Team, Professor of Orthopaedics, Primary Children's Hospital & Huntsman Cancer Institute, The University of Utah Salt Lake City, UT.

Part One: The Problem.- Bone Metastases: Epidemiology and Societal Effect.- Part Two: Biology of Metastases and Tissue of Origin Considerations.- Pathobiology of Osteolytic and Osteoblastic Bone Metastases.- Biology of Bone Cancer Pain.- Breast Cancer Bone Metastases.- Prostate Cancer Bone Metastasis.- Lung.- Kidney Metastatic Bone Disease.- Thyroid.- Myeloma.- Part Three: Work-Up for Patients with Suspected Metastatic Bone Disease.- Evaluation of the Patient with Carcinoma of Unknown Origin Metastatic to Bone.- Biopsy Considerations.- Part Four: Medical Therapy.- Bisphosphonates, Denosumab and Anabolic Agents in the Treatment of Metastatic Bone Disease.- Biotargeting in Metastatic Bone Disease.- Part Five: Supportive Oncology.- Psychosocial Considerations for Patients with Metastatic Bone Disease.- Pain Management in Metastatic Bone Disease.- When is Hospice Appropriate?  The Role for Hospice in Palliating Patients with  Bone Metastases.- Part Six: Radiation Oncology.- Current andEmerging Modalities.- Part Seven: Interventional Oncology.- Ablation and Cementation Technologies.- Part Eight: Principles of Orthopaedic Surgical Oncology.- Issues Facing the Established Metastatic Bone Disease Patient, Timing/Indications for Surgery.- Questions to Ask Your Medical Oncology Colleagues.- Consideration of the Temporal Relationship between Surgery and Radiation Therapy.- Role of Surgery in Oligometastatic Disease.- Part Nine: Specific Anatomic Considerations for Surgery.- Metastatic Bone Disease: Pelvis.- Metastatic Bone Disease: Femur.- Metastatic Bone Disease: Femur: Tibia.- Metastatic Bone Disease: Foot.- Metastatic Bone Disease: Femur: Humerus, Scapula.- Metastatic Bone Disease: Forearm, Hand.- Metastatic Bone Disease: Spine.- Part Ten: Emerging Surgical Technologies.- Intraoperative Imaging and Navigation.- Part Eleven: Putting It All Together.- Integrative Approach with the Patient in Mind: A Glance Forward.