[Diagnosis and treatment of metastatic bone cancer]

Metastatic bone cancer is usually diagnosed by graphical examinations. On plain x-ray film, it demonstrates osteolytic change with bone destruction in most cases, so sclerotic change without bone destruction is observed in some cases. In the spine metastases, it is important to differentiate compression fracture of the osteoporosis from the pathological destruction of the metastatic cancer. Although on plain x-ray film, the differentiation of these two conditions is difficult in most cases, MRI is useful to differentiate them. The treatment plan for metastatic bone cancer must be carefully decided. Systemic examinations and evaluation of the patient's general condition must be performed before treatment is started. There are conservative treatments such as chemotherapy, radiotherapy, hormone therapy and immune therapy, and operative treatment for metastatic bone cancer patients. Radiotherapy is useful for the pain caused by spinal cancer invasion. As a rule, operative treatment is indicated for the patients with the life expectancy of six months or more. But recently, with the progress of operative technique and implant material, more aggressive operative indication is proposed to improve the quality of life of the patients.