RT Journal
A1 Biermann, J. Sybil
A1 Holt, Ginger E.
A1 Lewis, Valerae O.
A1 Schwartz, Herbert S.
A1 Yaszemski, Michael J.
T1 Metastatic Bone Disease: Diagnosis, Evaluation, and Treatment
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2009
FD June 1
VO 91
IS 6
SP 1518
OP 1530
DO 
UL http://dx.doi.org/
AB 
Metastatic bone disease is a major health-care issue, affecting 4.9 million individuals in the United States. The cost of bone metastasis from cancer was estimated to be thirteen billion dollars per year in the United States in 20051, and the annual incident number of cancer cases in the United States is expected to double over the next fifty years2. With improved medical treatment of many cancers, patients are living longer, which places them at increased risk for the development of metastatic disease3,4. The skeleton is the third most common target of metastatic cancer and can be one of the earliest sites affected, especially in individuals with breast or prostate cancer. Ultimately, 60% to 84% of all cases of metastatic disease invade bone, and approximately 70% of patients with metastatic bone disease experience bone pain5. Patients with metastatic cancer involving bone are also at increased risk for fractures, spinal cord compression, hypercalcemia, and immobility resulting in substantial medical-associated morbidities.