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Cleveland Clinic Journal of MedicineMetastatic Bone Disease: Early Referral for Multidisciplinary Care

More than 50% of all cancers are estimated to develop bony metastases, significantly impacting patient quality of life and healthcare costs.

In the medical field, bone metastasis is a growing concern due to its widespread incidence, considerable healthcare costs, and substantial impact on patient quality of life. This article underscores the importance of an interdisciplinary approach to manage this condition, highlighting early recognition and timely referral for patients suspected of having metastatic bone disease.

Key Points:

  • Metastatic bone disease treatment has seen considerable advances over the last five decades; however, a lack of symptom recognition often results in delayed referrals to specialist teams.
  • The estimated yearly cost directly related to bone metastasis care in the US exceeds $12.6 billion.
  • Survival rates for patients with metastatic disease have significantly improved over the years, with over 50% of patients now surviving beyond ten years.
  • Early intervention has proven to reduce patient morbidity and overall cost. Early recognition and prompt referral to a specialist are critical in primary care settings for patients with suspected metastatic bone disease.

Additional Points:

  • Bone is the third most common organ affected by metastatic cancer after the lung and liver. The most frequent metastasis sites are the spine, pelvis, proximal femur, proximal humerus, skull, and ribs.
  • Quality of life is greatly compromised in patients with skeletal metastases, with events such as intractable pain, forced immobilization, and pathologic fractures being common.
  • Metastatic bone disease presentation typically occurs in three ways: detection during a routine investigation by an oncologist, patient admission with a pathologic or impending fracture, or referral by a primary care physician for musculoskeletal pain evaluation.
  • Metastatic bone disease management necessitates a multidisciplinary approach involving various specialists, and treatment aims to control pain, maintain or improve quality of life, allow early mobilization, and prevent disease progression.


  • Managing bone metastasis effectively necessitates early detection, a multidisciplinary approach, and well-coordinated interventions that focus on reducing pain, improving patient mobility, and enhancing quality of life.

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Did You Know?
It is projected that by 2030, the global burden of cancer will reach 21.6 million new cancer cases and 13 million cancer deaths annually.

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