Metastatic bone disease and tumour-induced hypercalcaemia: treatment options

Metastatic bone disease in malignancy is responsible for considerable morbidity and mortality. Problems include debilitating bone pain and skeletal-related events (SREs), including tumour-induced hypercalcaemia. This article provides an overview of the different approaches to managing bone disease in malignancy with particular focus on the role of bisphosphonates. The three generations of bisphosphonates are discussed in relation to their role in treating bone pain and hypercalcaemia, and also in terms of their potential for being used in a prophylactic way to prevent or delay SREs.