Multidisciplinary approach to the treatment of bone metastases: Osteo-Oncology Center, a new organizational model.
OBJECTIVE
Bone metastases are responsible for high morbidity in cancer patients. The frequency of pain and other serious complications associated with such metastases depends on the site and type of lesions and preventive therapy. The present paper aims to inform the scientific community about a new organizational health care model specifically designed for patients with bone metastases, in the hope of stimulating the creation of similar initiatives whose goals are to decrease the high morbidity of this pathology, reduce the frequency of complications, limit psychophysical distress of patients, and improve quality of life.


METHODS
In January 2005, an Osteo-Oncology Center was opened in our institute to provide multidisciplinary care (19 specialists involved) for patients with bone metastases, to train physicians, and to conduct research in the field.


RESULTS
In its first three years of activity, 601 multidisciplinary team consultations were made and a total of 425 patients were seen. The most frequent primary tumor site was the lung in males and the breast in females. Upon presentation at the Center, 79% of patients reported experiencing a level of pain (median pain intensity, 3.69) that interfered with normal daily activities. An anonymous questionnaire was also completed on the quality of the service provided: 75% of patients were very satisfied, 23% were satisfied, 1% responded "I don't know", and only 1% expressed dissatisfaction.


CONCLUSIONS
Our preliminary results confirm the usefulness of a multidisciplinary center for the management of patients with bone metastases, especially in terms of decreasing psychophysical suffering.
Ibrahim
Toni
T
Osteo-Oncology Center, Istituto Romagnolo Scientifico per lo Studio e la Cura dei Tumori (IRST), Meldola, Italy.
Flamini
Emanuela
E
Fabbri
Laura
L
Serra
Patrizia
P
Mercatali
Laura
L
Ricci
Rossana
R
Sacanna
Emanuele
E
Falasconi
Maria Cristina
MC
Casadei
Roberto
R
Galassi
Riccardo
R
Giannini
Massimo
M
Bazzocchi
Oscar
O
Calzolari
Filippo
F
Nunziatini
Roberta
R
Gaudio
Michele
M
Maltoni
Marco
M
Amadori
Dino
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary* / Q000628:therapy*; D002173:Cancer Care Facilities / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D018802:Patient-Centered Care / Q000458:organization & administration / Q000592:standards / Q000639:trends; D011788:Quality of Life; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000517:prevention & control