[Multidisciplinary Management of Bone Metastases in Clinical Practice]

Bone metastases occur in approximately two-thirds of patients with advanced cancer and are associated with pain, fractures, and neurological complications. The recently revised Dutch multidisciplinary guideline on bone metastases emphasizes early diagnosis, personalized treatment, and coordinated multidisciplinary care. We present three clinical cases highlighting key aspects of management: delayed diagnosis leading to femoral destruction and loss of mobility; a missed opportunity for prophylactic fixation in a patient with limited prognosis; and curative-intent stereotactic radiotherapy for a solitary bone metastasis. These cases illustrate the importance of timely imaging, appropriate surgical and radiotherapeutic interventions, and the use of bone-strengthening agents where indicated. Patients with bone metastases are a heterogeneous group; treatment decisions should take tumor type, extent of disease, patient condition,prognosis, and the preferences of patients into account. Implementation of the guideline requires collaboration across specialties to improve outcomes and quality of life for patients with bone metastases.