(v) The non-surgical management of musculoskeletal malignancy

Metastatic bone disease is a common clinical problem that requires a multidisciplinary approach in order to reduce patient suffering and maintain quality of life. Almost all patients with metastatic bone disease will have incurable cancer and this needs to be remembered when considering how to treat these patients. Conversely primary musculoskeletal cancers are rare conditions that need to be managed by specialist centres. Multimodality treatment is needed which may last for many months and may be associated with considerable toxicity. Patients with localised disease can possibly be cured but those with sarcoma remain with a guarded prognosis.