Impact of Bone Metastases on Patient's Quality of Life and Importance of Treatment

ObjectivesCancer patients with bone metastases are at a high risk for developing skeletal complications such as pathologic fractures, bone pain, or spinal cord compression. Available treatment options and study data demonstrating the impact of these skeletal-related events (SREs) on the patient's quality of life are highlighted in this review.MethodsStudies were identified and researched through PubMed.ResultsPathologic fractures affect many aspects of a patient's quality of life. Many of these fractures do not heal properly without treatment and require rehabilitation to restore function. In addition, patients may have pain that is refractory to standard therapy. Furthermore, fractures negatively affect survival in patients with prostate cancer. Vertebral metastases may cause patients to have motor impairment, pain, and neurologic complications. Bisphosphonates are able to effectively reduce skeletal complications. Zoledronic acid significantly reduced the proportion of men who experienced at least one SRE over 2 years on study compared with placebo (p = 0.028). Zoledronic acid also demonstrated a significant 5-month delay in the median time to first SRE (p = 0.009). Moreover, men without pain at study entry had a 39% relative reduction in the incidence of skeletal complications.ConclusionsBone metastases in patients with prostate cancer are associated with skeletal morbidity that may be refractory to treatment and can negatively affect quality of life. Zoledronic acid fulfills the need to reduce skeletal complications and should be considered in this patient population to delay the onset of these complications and improve pain control.