Chapter 64 – Localized Osteolysis

Publisher Summary This chapter reviews osteolytic bone disease and osteoporosis, with major attention on osteolytic and osteoblastic bone disease. It focuses primarily on myeloma, breast cancer, prostate cancer, and myeloma as true malignancies which exemplify the spectrum of bone changes that occupy advanced cancer. Metastatic bone disease occurs commonly in solid tumors of the breast, prostate and lungs. These are the three commonest solid tumors that affect humankind, and they are usually associated with bone metastasis at the stage that the patient has advanced disease. Patients with metastatic bone disease due to these solid tumors have a marked impairment of their quality of life due to skeletal-related events such as intractable bone pain, bone fragility, and susceptibility to pathologic fracture. This study also describes the osteolytic and osteoblastic process in breast cancer, and the important cell-cell interactions that occur in the bone microenvironment. Following this, it deals with prostate cancer and bone metastasis. Furthermore, multiple myeloma is a hematological malignancy which is characterized by the development of a progressive and destructive osteolytic bone disease which differs from the osteolysis frequently seen with solid tumors. Finally, deals with the occurrence of osteoporosis in patients with cancer.