The Journal of Bone and Joint Surgery (American). 2009;91:1518-1530.
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Metastatic Bone Disease: Diagnosis, Evaluation, and Treatment

J. Sybil Biermann, MD1, Ginger E. Holt, MD2, Valerae O. Lewis, MD3, Herbert S. Schwartz, MD2 and Michael J. Yaszemski, MD, PhD4

1 University of Michigan Hospitals, 1500 East Medical Center Drive, CC 7304/5946, Ann Arbor, MI 48109-5946. E-mail address: biermann@med.umich.edu
2 Vanderbilt Orthopaedic Institute, Medical Center East, South Tower Suite 4200, 1215 21st Avenue South, Nashville, TN 37232-8774. E-mail address for G.E. Holt: ginger.e.holt@vanderbilt.edu. E-mail address for H.S. Schwartz: herbert.s.schwartz@vanderbilt.edu
3 MD Anderson Cancer Center, P.O. Box 301402, Unit 444, Houston, TX 77230-1402. E-mail address: volewis@mdanderson.org
4 Mayo Clinic, 200 First Street S.W., Rochester, MN 55905. E-mail address: yaszemski.michael@mayo.edu

An Instructional Course Lecture, American Academy of Orthopaedic Surgeons

The first 150 words of the full text of this article appear below.


   Introduction
 
Metastatic bone disease is a major health-care issue, affecting 4.9 million individuals in the United States. The cost of bone metastasis from cancer was estimated to be thirteen billion dollars per year in the United States in 20051, and the annual incident number of cancer cases in the United States is expected to double over the next fifty years2. With improved medical treatment of many cancers, patients are living longer, which places them at increased risk for the development of metastatic disease3,4. The skeleton is the third most common target of metastatic cancer and can be one of the earliest sites affected, especially in individuals with breast or prostate cancer. Ultimately, 60% to 84% of all cases of metastatic disease invade bone, and approximately 70% of patients with metastatic bone disease experience bone pain5. Patients with metastatic cancer involving bone are also at increased risk for . . . [Full Text of this Article]


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