Metastatic Spine Lesions
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Metastatic lesions in the spine can be osteolytic, osteoblastic, or mixed based on CT/MRI imaging. Osteolytic lesions appear destructive and lytic, risking fracture and requiring stabilization. Osteoblastic lesions stimulate new bone formation and may require decompression. Mixed lesions show both lytic and blastic features.
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This document discusses the use of adult stem cells, specifically mesenchymal stem cells (MSCs), in orthopedics. It provides several examples of how MSCs derived from bone marrow have been used to treat orthopedic injuries and conditions. These include using bone marrow concentrate to treat non-unions, avascular necrosis, and promote healing in ACL reconstruction, spinal fusions, and rotator cuff injuries. Studies show MSCs can reduce healing times and promote stronger tissue regeneration compared to other treatments like corticosteroids or autografts. The document also discusses how MSCs may help regenerate cartilage and treat osteoarthritis by reducing pain and slowing degeneration.
Skeletal Related Events in Metastasis Breast Cancer: Case Report_Crimson Publ...
Skeletal Related Events in Metastasis Breast Cancer: Case Report_Crimson Publ...CrimsonpublishersCancer
Breast cancer is the most common malignancy distressing females in the world. The bone metastases are one of the most common site of disease dissemination. Up to 75% of stage IV Breast cancer patients developing skeletal metastases [1] metastatic bone disease can result in skeletal related events (SREs), including humoral hypercalcaemia of malignancy (HHM), pathological fractures, spinal cord compression, and pain [2]. The median time from bone metastases diagnosis to first SRE can be as short as 1.8 months, with the incidence of SREs growing considerably during the first 12 months following diagnosis [3]. This Bone metastases affect patient survival, movement, and quality of life by negative impact. The molecular mechanisms involved in the metastasis, colonization, and proliferation of breast cancer cells in bone are multifaceted and include crosstalk between breast cancer cells and the bone microenvironment. The capability of metastatic breast cancer cells to capture normal biological processes involved in bone remodeling is a key driver of osteolytic and osteoblastic bone lesions. As such, our understanding of how breast cancer cells manipulate normal bone remodeling pathways is essential for the development of new therapeutic agents to improve patient outcomes.Potential of Targeting Bone Metastases with Immunotherapies_Crimson Publishers
Potential of Targeting Bone Metastases with Immunotherapies_Crimson PublishersCrimsonpublishersCancer
Potential of Targeting Bone Metastases with Immunotherapies
Bone metastases are common in many cancers and result in low survival rates. Immunotherapies have shown promise in treating some patients with bone metastases. Case reports have shown individual patients experiencing decreased bone lesion growth or complete remission of bone metastases using immunotherapies targeting PD-1, PD-L1, or CTLA-4. However, immunotherapies may also cause harmful skeletal effects like fractures or spinal cord compression. Further research is still needed to determine if immunotherapies are effective against bone metastases in large patient groups and to understand their potential skeletal side effects.Bibliography: Cancer Ver 1.2
This document provides a bibliography of research papers related to cancer organized by topic. It includes 3-7 references for each of 17 cancer-related topics, such as 3D tumor imaging, angiogenesis, bladder cancer, breast cancer, contrast imaging, and others. The references provided for each topic are journal articles published between 2005-2010 that describe research on imaging, molecular markers, treatment responses, and other aspects of various cancers.
Adult Stem cells in Orthopaedics
Adult Stem cells in Orthopaedics present and future perspectives.
Παρουσίαση του Δρ. Σταύρου Αλευρογιάννη που έγινε στο ξενοδοχείο Χίλτον, στις 12/06/15 στα πλαίσια Ημερίδας της Ελληνικής Εταιρείας Αναγεννητικής Ιατρικής, Αντιγήρανσης και Βιοτεχνολογίας, στο 41ο Πανελλήνιο Ιατρικό Συνέδριο.
"H θέση της αναγεννητική Ιατρικής στις παθήσεις Οστών και Αρθρώσεων"
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Men in the lower third of muscular strength had higher rates of mortality than those in the middle or upper thirds. A study of over 3,000 women with breast cancer found that low muscle mass and quality were associated with higher mortality. Older age is a major risk factor for poor outcomes from influenza, COVID-19, and critical illness due to the impacts of aging on muscle loss and frailty. Fortetropin has been shown to increase muscle mass and strength in humans and prevent disuse muscle atrophy in dogs after surgery.
Alberto Bazzocchi , today multiparametric imaging of bone and soft tissue tum...
Alberto Bazzocchi , today multiparametric imaging of bone and soft tissue tum...JFIM - Journées Francophones d'Imagerie Médicale
Alberto Bazzocchi
today multiparametric imaging of bone and soft tissue tumours
jfim ifupi milan 2018UROLOGIC NURSING November-December 2019 Volume 39 Number.docx
UROLOGIC NURSING / November-December 2019 / Volume 39 / Number 6 293
Rikka Burroughs, DNP, BA, ARNP, AGPCNP-C, CUNP, is a Nurse Practitioner, Physicians’
Clinic of Iowa, Cedar Rapids, IA and University of Iowa College of Nursing, Iowa City, IA.
Bone Health Assessment in Men
On Androgen Deprivation Therapy
For Prostate Cancer: A Nurse
Practitioner-Led Quality
Improvement Protocol
Rikka Burroughs
P
rostate cancer is the most
common solid organ
cancer and is the second
leading cause of cancer
mortality for men in the United
States (American Cancer Society
[ACS], 2018; American Uro -
logical Association [AUA],
2018). An d rogen dep rivation
therapy (ADT) is a common ther-
apy for locally advanced prostate
cancer, and is the mainstay of
treatment for metastatic and bio-
chemically recurrent prostate
cancer (Loblaw et al., 2007;
National Comprehensive Cancer
Network [NCCN], 2017). Al -
though an effective treatment for
prostate cancer, ADT causes
accelerated loss of bone mass,
leading to increased risk for frac-
ture (Chahin, Gualamhusein,
Breunis, & Alibhai, 2016; Damji,
Bies, Alibhai, & Jones, 2015).
Approximately 1 in 2 men
(44.8%) diagnosed with prostate
cancer and on Medicare will
receive ADT, many for 2 years or
longer (Gilbert, Kuo, & Shahinian,
2011; Meng et al., 2002); the actu-
al incidence of prostate cancer in
the full U.S. population of men is
unknown. ADT can cause mor-
bidities that are often inadequate-
ly addressed (NCCN, 2017). Two
such sequelae are osteopenia and
secondary osteoporosis (Chahin
et al., 2016; NCCN, 2017).
Substantial bone loss can occur
within the first 6 months of ADT
therapy (Datta & Schwartz, 2012).
In fact, 1 in 10 men treated with
ADT will sustain a new fracture
within 24 months of treatment
initiation (Datta & Schwartz,
2012). About 6 in 10 men diag-
nosed with prostate cancer are
over age 65 years, and when
screened, as many as half of these
men are noted to have low bone
mass prior to initiation of ADT
(ACS, 2018; Panju et al., 2009).
Therefore, ADT treatment places
them at even further risk of frac-
ture (Panju et al., 2009).
Significance of the Problem
Osteoporosis-related frac-
tures are associated with in -
creased morbidity and mortality
(Walsh & Eastell, 2013). Low bone
© 2019 Society of Urologic Nurses and Associates
Burroughs, R. (2019). Bone health assessment in men on androgen deprivation
therapy for prostate cancer: A nurse practitioner-led quality improvement
protocol. Urologic Nursing, 39(6), 293-301 doi:10.7257/1053816X.2019. -
39.6.293
Androgen deprivation therapy (ADT) causes bone loss. Despite this, there is sub-
stantial variability in clinical practice related to bone health prevention and treat-
ment for men with prostate cancer receiving ADT. This quality improvement proj-
ect facilitated consistency in providing evidence-based care for bone health in
men with prostate cancer on ADT at a private urology clinic.
Ke ...
UROLOGIC NURSING November-December 2019 Volume 39 Number.docx
Androgen deprivation therapy (ADT) for prostate cancer increases risk of bone loss and fracture. However, guidelines for bone health screening and treatment are not consistently followed for men on ADT. This quality improvement project implemented a protocol for urologists to refer patients on ADT to a nurse practitioner specializing in bone health within 90 days of starting ADT. The protocol increased timely referrals and lab testing, and improved urologists' bone health knowledge to better address this important issue.
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Metastatic Spine Lesions
- 1. METASTATICSPINELESIONS: OSTEOLYTICVERSUSOSTEOBLASTIC Ade Wijaya, MD – December 2018
- 2. INTRODUCTION • Spinal metastasis is common breast, prostate, lung, and renal cancer • Metastatic spread to the spine is characterized in three ways: - Osteolytic (lytic, destructive) - Osteoblastic (blastic, constructive) - Mixed (both lytic and blastic) • CT/MRI was used to determine whether the metastatic lesion was lytic, blastic, or mixed Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277–300. Khan SN, Donthineni R. Surgical management of metastatic spine tumors. Orthop Clin North Am.2006;37:99–104. Mundy GR. Metastasis to bone: Causes, consequences and therapeutic opportunities. Nat Rev Cancer.2002;2:584–93.
- 3. RADIOLOGY Lytic lesions appeared destructive, showing loss of both cancellous and cortical bone, and were usually well circumscribed Reddington JA, Mendez GA, Ching A, Dai Kubicky C, Klimo Jr P, Ragel BT. Imaging characteristic analysis of metastatic spine lesions from breast, prostate, lung, and renal cell carcinomas for surgical planning: Osteolytic versus osteoblastic. Surgical neurology international. 2016;7(Suppl 13):S361.
- 4. RADIOLOGY Blastic lesions appeared hyperdense, were typically expansile, and had poorly defined borders Reddington JA, Mendez GA, Ching A, Dai Kubicky C, Klimo Jr P, Ragel BT. Imaging characteristic analysis of metastatic spine lesions from breast, prostate, lung, and renal cell carcinomas for surgical planning: Osteolytic versus osteoblastic. Surgical neurology international. 2016;7(Suppl 13):S361.
- 5. RADIOLOGY Mixed lesions Reddington JA, Mendez GA, Ching A, Dai Kubicky C, Klimo Jr P, Ragel BT. Imaging characteristic analysis of metastatic spine lesions from breast, prostate, lung, and renal cell carcinomas for surgical planning: Osteolytic versus osteoblastic. Surgical neurology international. 2016;7(Suppl 13):S361.
- 6. Reddington JA, Mendez GA, Ching A, Dai Kubicky C, Klimo Jr P, Ragel BT. Imaging characteristic analysis of metastatic spine lesions from breast, prostate, lung, and renal cell carcinomas for surgical planning: Osteolytic versus osteoblastic. Surgical neurology international. 2016;7(Suppl 13):S361.
- 7. Guise TA, Mohammad KS, Clines G, Stebbins EG, Wong DH, Higgins LS, Vessella R, Corey E, Padalecki S, Suva L, Chirgwin JM. Basic mechanisms responsible for osteolytic and osteoblastic bone metastases. Clinical cancer research. 2006 Oct 15;12(20):6213s-6s.
- 8. SURGICAL CONSIDERATIONS Lytic lesions are associated with loss of bone and structural integrity with a risk of pathologic fracture, necessitating preoperative consideration for stabilization (e.g., graft reconstruction and planning fixation for screws) Blastic lesions tend to stimulate bone formation that can add to cord compression, decompression may be the key surgical goal. Fidler MW. Pathological fractures of the cervical spine.Palliative surgical treatment. J Bone Joint Surg Br.1985;67:352–7.
- 9. SUMMARY • Metastatic spread to the spine is characterized in three ways: osteolytic, osteoblastic, and mixed • CT imaging to determine whether lesions are osteolytic, osteoblastic, or mixed • In cases of osteolytic lesions, the concern is of segmental instability requiring reconstruction and the risk for screw pull out should instrumentation be considered. • In cases of osteoblastic lesions, surgeons should consider debulking dense bone.