AN OVERVIEW OF THE BONE METASTASES PROGRAM UNIVERSITY OF CINCINNATI CANCER INSTITUTE LARRY W. PETERS PROGRAM COORDINATOR

CANCER STATISTICS-NATIONAL CANCER INSTITUTE IN 2018, AN ESTIMATED 1,735,350 NEW CASES OF CANCER WILL BE DIAGNOSED IN THE UNITED STATES AND 609,640 PEOPLE WILL DIE FROM THE DISEASE. CANCER STATISTICS 2018 APRIL 27 NATIONAL CANCER INSTITUTE HTTPS://WWW.CANCER.GOV/ABOUTCANCER/UNDERSTANDING/STATISTICS

AT THE UNIVERSITY OF CINCINNATI CANCER INSTITUTE, WE ARE VERY HAPPY TO HAVE AN ORGANIZED AND STREAMLINED PROCESS AVAILABLE FOR THE EVALUATION AND TREATMENT OF PATIENTS WITH BONE METASTASES. THE HOPE IS TO PREVENT PATHOLOGIC FRACTURES AND MINIMIZE CURRENT OR IMPENDING SYMPTOMS ASSOCIATED WITH BONE METASTASES.

BONE METASTASES IS WHERE MALIGNANT CELLS HAVE TRAVELED TO THE BONES FROM OTHER PARTS OF THE BODY.

AT UCCI, OUR TEAM OF RADIOLOGY ONCOLOGISTS AND ORTHOPAEDIC SURGEONS LEAD THE WAY IN OUR BONE METASTASES PROGRAM.

THE ROLE OF OUR ORTHOPAEDIC SURGEONS IN THE MANAGEMENT OF METASTATIC BONE DISEASE FALLS INTO 3 PRINCIPLE CATEGORIES.

BREAST CANCER WITH BONE METS STAGE 2 BREAST CANCER 5 YEAR SURVIVAL RATE IS OVER 90%. STAGE 3 BREAST CANCER 5 YEAR SURVIVAL RATE IS 72%. STAGE 4 BREAST CANCER 5 YEAR SURVIVAL RATE IS 22%. IN BREAST CANCER, BONE METS MOST COMMONLY APPEAR IN THE SPINE, RIBS, SKULL, PELVIS, AND UPPER BONES OF THE ARMS AND LEGS

LUNG CANCER AND BONE METS 30-40% OF PEOPLE WITH ADVANCED LUNG CANCER WILL DEVELOP BONE METS. THEY MOST COMMONLY TRAVEL TO THE SPINE, PELVIS AND UPPER BONES OF THE ARMS AND LEGS. IT CAN ALSO SPREAD TO THE BONES IN THE HANDS AND FEET. SURVIVAL IS USUALLY LESS THAN 6 MONTHS. LEARNING THAT YOU HAVE BONE METS FROM LUNG CANCER MEANS THAT YOUR CANCER IS STAGE 4 AND IS NO LONGER CURABLE. ZERO (N.D.) ZERO – THE END OF PROSTATE CANCER HTTPS://ZEROCANCER.ORG/LEARN/CURRENT-PATIENTS/ADVANCED-CANCER/PROSTATE-CANCER-MET

MORE THAN 60% OF MEN WITH ADVANCED PROSTATE CANCER WILL EVENTUALLY DEVELOP BONE METS, MOST COMMONLY IN THE SPINE, HIPS AND RIBS.

RED FLAG SYMPTOMS OF METASTATIC BONE DISEASE GROND S, ZECH D, DIEFENBACH C, ET AL. ASSESSMENT OF CANCER PAIN; A PROSPECTIVE EVALUATION IN 2266 CANCER PATIENTS REFERRED TO A PAIN SERVICE. PAIN. 1996;64 (1): 107-114 HTTP://WWW.MOFFITT.ORG/FILE%20LIBRARY/MAIN%20NAV/RESEARCH%20AND%20CLINICAL%

FINDING BONE METASTASES: BONE METASTASES ARE SOMETIMES FOUND BECAUSE THEY CAUSE PROBLEMS. BUT IN SOME CASES, THEY’RE FOUND BEFORE THE PATIENT HAS ANY SYMPTOMS. LAB AND IMAGING TESTS ARE OFTEN USED TO SEE IF AND/OR HOW FAR THE CANCER HAS SPREAD. SOME OF THESE TESTS MAY INCLUDE BONE SCAN, CT SCAN, MRI, PET, AND BIOPSY.

TREATMENT OPTIONS DEPEND ON: WHAT TYPE OF PRIMARY CANCER THAT YOU HAVE WHICH BONES AND HOW MANY THE CANCER HAS SPREAD TO WHETHER ANY BONES HAVE BEEN WEAKNED OR BROKEN WHICH TREATMENTS YOU HAVE ALREADY HAD YOUR SYMPTOMS AND GENERAL STATE OF HEALTH.

TREATING BONE METASTASES TWO MAIN TYPES OF TREATMENT FOR BONE METASTASES: SYSTEMIC TREATMENTS (WHICH GO THRU THE WHOLE BODY) LOCAL TREATMENTS WHICH TREAT ONLY THE CANCER IN THE BONE DEPENDING ON THE EXTENT AND LOCATION OF THE METASTASES, ONE OR BOTH OF THESE TYPES OF TREATMENT MAY BE USED. JOURNAL LIST>ONCOL REV.>V.11(1)J 2017 MAR 3>PMC 5444408 HTTP://WWW.NCBI.NLM.NIH.GOV/MC/ATICLES/PMC5 444408

MANAGING PATIENTS WITH METASTATIC BONE DISEASE BONE METASTASES CAN SIGNIFICANTLY COMPROMISE QUALITY OF LIFE AND MAY NEGATIVELY AFFECT SURVIVAL. PRIMARY OBJECTIVES OF MANAGING METASTATIC BONE DISEASE: PALLIATION OF PAIN PREVENTION OF SKELETAL COMPLICATIONS MAINTENANCE OF QUALITY OF LIFE

PHYSICAL ACTIVITY THERE IS INCREASING EVIDENCE FOR THE BENEFITS OF PHYSICAL ACTIVITY IN PEOPLE LIVING WITH CANCER.

PHYSICAL ACTIVITY AND PALLIATIVE CARE EVEN IN A PALLIATIVE CARE SETTING, STUDIES SHOW THAT PHYSICAL ACTIVITY CAN HAVE SIGNIFICANT BENEFITS. MACMILLAN CANCER SUPPORT (N.D.); THE IMPORTANCE OF PHYSICAL ACTIVITY FOR PEOPLE LIVING WITH AND BEYONE CANCER: A CONCISE EVIDENCE REVIEW MACMILLAN.ORG.UK/DOCUMENTS/ABOUTUS/COMMISSIONERS/PHYSICALACTIVITYEVIDENCEREVIEW.PDF

PHYSICAL ACTIVITY AND ADVANCED CANCER MANY PEOPLE WITH ADVANCED CANCER WOULD LIKE TO BE MORE PHYSICALLY ACTIVE. THE AMERICAN CANCER SOCIETY (N.D.) NUTRITION AND PHYSICAL ACTIVITY GUIDELINES FOR CANCER SURVIVORS ONLINELIBRARY.WILEY.COM/DOI/10.3322/CAAC.21142/EPDF

BONE METASTASES REFERRALS I AM AVAILABLE AS THE FIRST POINT OF CONTACT FOR YOUR REFERRALS. YOU MAY CONTACT ME BY E-MAIL AT: (LARRY.PETERS@UCHEALTH.COM). BY PHONE AT: (513) 584-4068. FROM THERE, I WILL COORDINATE RAPID AND APPROPRIATE EVALUATION BY APPROPRIATE SERVICES (ORTHOPAEDICS, RADIATION ONCOLOGY, NUCLEAR MEDICINE, HEMATOLOGY/ONCOLOGY, ETC). PLEASE CONTACT ME WITH ANY PATIENTS THAT COULD BENEFIT FROM THIS SERVICE.