Managing metastatic bone disease: three case studies

Metastatic bone disease constitutes a major clinical problem. Skeletal complications are common and lead to significant morbidity, and patients live with metastatic bone disease for several years, increasing the prevalence of this problem. Effective management aims to reduce the incidence of skeletal complications and relieve symptoms, such as severe bone pain, which adversely affect patient mobility and quality of life. This article describes and discusses strategies for managing metastatic bone disease, with particularly emphasis on the role of the bisphosphonate ibandronate. Two case histories show the long-term efficacy and tolerability of oral ibandronate in the treatment of metastatic breast cancer. The third case history illustrates the benefits of rapid pain relief from an intensive, high-dose regimen of intravenous ibandronate in metastatic prostate cancer.