Cancerous process of bone tissue destruction - tumor osteolysis
Osteolysis is a fast-acting process of bone tissue destruction resulting from tumor metastasis to the skeletal system. It involves increased bone destruction by its own bone cells called osteoclasts.
Photo.1 Healthy and strong bone structure
Photo 2. Osteolysis osteolysis osteolysis focal point - trabecular bone structure disappearing
Bone metastases to the bone are most often located in the spine, ribs, pelvis as well as in the femoral and humeral bones
The most important methods of inhibiting osteolysis and bone metastases include:
♦ radiotherapy
♦ hormonotherapy
♦ farm therapy for bisphosphonates
♦ glucocorticoids
♦ sometimes surgical resections of single metastases are used
♦ in the case of pathological changes in the spine that threaten fractures, it is sometimes recommended to use corsets that provide external support for the weakened skeleton.
Radiotherapy combats the pain caused by the effects of osteolysis
The basis of current painkillers is irradiation with radiotherapy of tumor foci in the bones. In 80% of patients it brings quick pain relief. In some patients, this improvement is permanent. If metastases are numerous, an intravenous infusion of a radioisotope is used, which along with the circulation reaches the cancerous foci throughout the body. Radiotherapy is not painful, it brings clear improvement.
Hormone therapy prevents the metastasis of hormone-dependent tumors
In the suppression of hormone-dependent metastases of malignant tumors of the breast and prostate, hormonal therapy is also used. Hormonal treatment to prevent metastases of breast cancer to the bone is like in the prevention of breast cancer to lower the level of female hormones. In addition, calcitonin is used that promotes calcification of bone weakened ostolysis.
Biphosphonate pharmacotherapyand
Due to the risk of fractures as well as systemic, deleterious effects of bone calcium escape (hypercalcaemia), calcium binding drugs - bisphosphonates are commonly used. In Poland, a number of such medicines are currently registered on the basis of such medicinal substances as clodronate and pamidronate. Bisphosphonates are used primarily in patients with breast cancer complicated by bone metastases, although positive treatment effects have also been found in patients with prostate cancer and multiple myeloma.
The use of bisphosphonates in such cases allows to limit further metastases and inhibit the development of already existing cancer foci.
Bisphosphonates strengthen bones
Bisphosphonates are built into the bone mineral matrix and strengthen the bone structure. This enhancement protects the bone from degeneration and destruction that bone-related cells constantly carry out (in contrast to the constant bone regeneration of osteogenic cells). This is important, because the cancerous focus intensifies the activity of the bony cells.
Biphosphonates block the activitybone-bones destroying the bone
Secondly, they limit the numerical development and the ability of the bone cells to move to the appropriate bone site, which hinders their effective functioning. This allows to effectively reduce the activity of bone cells responsible for the rapid destruction of bone tissue and the associated pain and bone fractures.
The use of bisphosphonates in the early stage of bone metastases is particularly advantageous in a prolonged manner
Chronic use of bisphosphonates reduces the risk of subsequent metastases.In a study at the university hospital in Haidelberg, it was determined that clodronate administered 2 years to patients with breast cancer, with their presence in the presence of cancer cells in the bone marrow - significantly reduced the number of new bone metastases. What is also important was the reduction of metastases, not only to the bones, but also to the visceral organs (lungs, liver, etc.). Most cancers have the ability to release their cells into the blood and transfer them to the bones and other organs.
Prophylaxis of bisphosphonate bone metastases?
Can higher-hopes for safer prophylaxis against multiple neoplastic metastases be associated with bisphosphonates? Certainly yes. It is already known that the use of bisphosphonates on time allows to maintain much longer physical fitness and permanently get rid of severe pain, sometimes without the need for additional painkillers. Thus, they help to maintain the necessary minimum of life comfort in patients.
ed. Edward Ozga Michalski
consultation - dr n. med. Ewa Krzęcio
