[Tumour-modifying therapy]

Symptom relief as well as symptom prevention may be achieved in patients with advanced malignant disease and short life expectancy by use of radiotherapy and systemic cancer treatment (hormones and chemotherapy). Sometimes the treatment may be life prolonging as well. This knowledge is mostly based upon empirical data and personal experiences - to a much lower extent on evidence-based medicine. For these patients, it is of particular importance to minimise the level and duration of acute treatment-related toxicity. Shortened radiotherapy regiments may be effective, with few side effects. The efficacy of the systemic treatment must be evaluated at regular intervals and terminated if there is a lack of response or high level of toxicity. Bisphosphonates are standard treatment of hypercalcaemia. In addition, in patients with bone metastasies from various cancer sites with a life expectancy of six months or more, bisphosphonates may reduce the number of skeletal events.