The American Cancer Society estimates that 383,000 Americans will be diagnosed with prostatic or breast cancer in 1994.[1] Many of these individuals will develop painful bony metastases. As clinicians, it is imperative that we seek out the most current information on anticancer and palliative breakthroughs for these patients.
Although treatments such as radiotherapy and hormonal therapy have been used for many years, they are constantly being refined in order to optimize both efficacy and safety. Cancer chemotherapy is also continually evolving. Our awareness of developments in these fields is critical to patient care. One of the goals of this supplement is to provide reviews of the current status of these conventional approaches.
With disease progression, the effective management of pain becomes an overriding concern. In fact, it is the physician's obligation and ethical responsibility to alleviate suffering and provide optimal pain relief throughout the course of cancer.[2 ]
Several of the papers included herein focus on strontium-89, the radiopharmaceutical that was approved by the US Food and Drug Administration in the summer of 1993 for the palliation of pain from bony metastases. The drug can make a dramatic impact on the quality of life of many cancer patients only if information concerning its efficacy, safety, and administration, as well as patient selection and follow-up, is properly disseminated. It is our hope that this supplement will help meet this goal.
A 70-year-old man with a history of localized prostate cancer treated with whole-pelvis radiation therapy with a boost to the prostate, in conjunction with androgen deprivation therapy 7 years prior, presented with lower back pain. A bone scan revealed an area of activity in the sacrum. What is the most likely diagnosis?
