The use of bisphosphonates in the management of bone metastatic prostate cancer.
Improved understanding of the pathophysiology of prostate cancer-induced metabolic bone disease implies that bisphosphonates may have a role in the treatment of this disorder. Although prostate cancer cells stimulate osteoblasts, resulting in a marked increase in bone volume and the classic radiologic aspect of sclerotic metastases, accelerated bone resorption has been reported by histomorphometric and biochemical studies. The significant relationship between the biochemical parameters of bone resorption and formation suggests a coupling between these two processes in metastatic prostate cancer. Several studies have demonstrated that administration of bisphosphonates is one of the most cost-effective palliative treatments for patients with prostate carcinoma and bone metastases, both as first-line and long-term therapy. With appropriate doses, a large proportion of patients can be maintained free of bone pain until death. Studies of the efficacy of lower doses to prevent skeletal morbidity in patients without metastases or with asymptomatic bone lesions are warranted.
Mercadante
Sebastiano
S
Anestesia and Intensive Care Unit & Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Via S. Lorenzo 312, Palermo, 90146, Italy. mercadsa@tin.it
D001859:Bone Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D001842:Bone and Bones / Q000378:metabolism; D004164:Diphosphonates / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000378:metabolism / Q000473:pathology*
D004164:Diphosphonates