Metastatic disease Flashcards
Describe common causes and sites for bone metastases
- Most common causes → breast cancer, lung cancer and prostate cancer
- Most common sites → spine (most common) > pelvis > ribs > skull > long bones
*Spine = most common site of bone metastases. Back pain worse when sneezing/coughing, worse at night, associated with tenderness.
What are the features of bone metastases?
Features → bone pain, pathological fractures, hypercalcaemia, raised ALP
- Important to exclude Cauda Equina Syndrome due to bone metastases
- Hypercalcaemia + raised ALP = bone metastases
How would you treat bone metastases?
Treatment → pain management (radiotherapy), chemotherapy, bisphosphonates for pain (inhibit bone resorption), surgery (if pathological fractures or spinal cord compression)
- Neoplastic spinal cord compression = high-dose oral dexamethasone whilst waiting imaging
What are the common causes of brain metastases?
Most common causes → lung cancer (most common), breast cancer, bowel cancer, melanoma, renal cell carcinoma
What are the features of brain metastases?
Features → seizures, focal neurological deficits, cognitive deficits, headaches
How are brain metastases treated?
Treatment → surgical resection or stereotactic radiosurgery. Patients with poor functional status may be treated palliatively.
What are the common causes of lung metastases?
Most common causes → breast cancer, colorectal cancer, renal cell carcinoma, prostate cancer, bladder cancer, melanoma
What investigations are used to detect lung metastases?
CXR → multiple rounded lesions (’cannonball metastases’) which are most commonly due to renal cell cancer (CT CAP to investigate this)
How is lung metastases treated?
Chemotherapy is the most common treatment for lung metastases. It is used to help shrink and control the growth of cancer. Chemotherapy is sometimes used along with other treatments such as surgery and targeted therapy. Chemotherapy drugs circulate (flow) throughout the body to destroy cancer cells
