Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020437 (hypercalcemia)
 10,293 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The diagnosis of bone metastases can be a devastating occurrence for any woman with breast cancer. In this setting, bone metastases can result in skeletal-related events (SREs) such as pathologic fracture, spinal cord compression, and hypercalcemia. Several trials have confirmed the ability of bisphosphonates to reduce or delay these skeletal complications, and they should now be considered standard care for these women. The analysis of SREs is the typical primary end point in bisphosphonate studies. While not undermining their importance, the definition of SREs does not include complications important to patients, such as pain and immobility. It is these symptoms that are most frequently reported by patients, and bone pain and quality of life (QoL) are often measured as secondary end points in these trials. Bone pain and QoL measures are not standardized and are difficult to compare among patient populations. We do not yet know the true efficacy of bisphosphonates as analgesics or how they impact QoL. This paper reviews the current efficacy measures used in recent bisphosphonate trials and discusses their benefits and limitations. It also explores the role of bone biomarkers and their potential use in monitoring treatment response.
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PMID:Too much, too little, too late to start again? Assessing the efficacy of bisphosphonates in patients with bone metastases from breast cancer. 1654 6

Metastasis to the skeleton frequently occurs in breast carcinoma patients resulting in different skeletal-related events including pain, hypercalcemia, pathological fracture, and spinal cord or nerve root compression. Bisphosphonates are class of agents most frequently used to reduce skeletal-related events in patients with bone metastases by inhibiting osteoclast activity through inhibition of mevolanate pathway which is also important in cholesterol synthesis. Statins are cholesterol lowering agents and inhibit the same pathway. Therefore statins may also reduce skeletal-related events in breast cancer patients with bone metastases by inhibiting osteoclastic activity.
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PMID:Statins may decrease skeletal-related events in breast cancer patients with bone metastases. 1684 15

Bone metastases are a common occurrence in patients with breast cancer, lung cancer and prostate cancer. Bone metastases cause considerable morbidity including pain, impaired mobility, pathologic fracture, spinal cord or nerve root compression, bone marrow infiltration and hypercalcemia of malignancy. These complications result from the derangement of normal bone metabolism that arise from interactions between factors originating in tumor cells and others originating in the microenvironment of the bone. Fortunately, there is an increasing array of treatment options for the skeletal complications associated with bone metastases arising from breast, lung, and prostate cancer. The goals of treatment for such skeletal complications are to relieve pain and reduce the risk of fracture. Traditional therapies to treat skeletal malignancies include radiation, surgery, and chemotherapy. In recent years, bisphosphonates have become the treatment of choice because of their ability to reduce bone resorption, leading to decreases in hypercalcemia, new osteolytic lesions, and fractures, thereby ameliorating pain and improving quality of life.
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PMID:Managing bone complications of solid tumors. 1696 20

Parathyroid carcinoma is a very rare cause of primary hyperparathyroidism and these tumors are usually hyper-functioning as compared to other malignant endocrine tumors. Surgery is the only effective primary treatment. We report a patient, who presented with pathological fracture of femur, hypercalcemia, bilateral renal stones, markedly raised Parathormone levels and palpable mass in the neck. Parathyroid adenoma was initially diagnosed and localized at left lower gland by Sestamibi scan and ultrasonography. She underwent surgery and enlarged parathyroid gland was removed. Intra operatively there was no evidence of local invasion or lymph nodes involvement but biopsy report suggested malignancy.
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PMID:Parathyroid carcinoma. 1697 24

The skeleton is the most common organ to be affected by metastatic cancer and the site of disease that produces the greatest morbidity. Skeletal morbidity includes pain that requires radiotherapy, hypercalcemia, pathologic fracture, and spinal cord or nerve root compression. From randomized trials in advanced cancer, it can be seen that one of these major skeletal events occurs on average every 3 to 6 months. Additionally, metastatic disease may remain confined to the skeleton with the decline in quality of life and eventual death almost entirely due to skeletal complications and their treatment. The prognosis of metastatic bone disease is dependent on the primary site, with breast and prostate cancers associated with a survival measured in years compared with lung cancer, where the average survival is only a matter of months. Additionally, the presence of extraosseous disease and the extent and tempo of the bone disease are powerful predictors of outcome. The latter is best estimated by measurement of bone-specific markers, and recent studies have shown a strong correlation between the rate of bone resorption and clinical outcome, both in terms of skeletal morbidity and progression of the underlying disease or death. Our improved understanding of prognostic and predictive factors may enable delivery of a more personalized treatment for the individual patient and a more cost-effective use of health care resources.
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PMID:Clinical features of metastatic bone disease and risk of skeletal morbidity. 1706 8

The incidence of bone metastasis has been increasing in all cancers in recent years. Bone metastasis is associated with substantial morbidity, including bone pain, pathological fracture, neurological deficit and/or hypercalcemia. Thus, the management of bone metastasis in patients is a clinically significant issue. In the process of bone metastasis, the primary mechanism responsible for bone destruction is cancer cell-mediated stimulation of osteoclastic bone resorption, which results in osteolysis and release of various growth factors from the bone matrix. These growth factors are prerequisites for successful colonization and subsequent invasive growth of cancer cells in bone, which is called a "vicious cycle." Thus, it is important to elucidate what molecules are involved in this step of bone destruction, and the understanding of these molecular mechanisms could lead to develop molecular-target therapies for bone metastasis. Bisphosphonates introduced in the treatment for bone metastasis have been shown to reduce skeletal morbidity. In Japan, the most potent bisphosphonate, zoledronate (ZOMETA), was introduced in this past April, and a phase III clinical trial of humanized anti-RANKL monoclonal antibody (Denosumab) against bone metastasis is under way as a global study. These new agents, which are targeted to osteoclasts, are considered to be standard management in the care of bone metastasis patients in combination with chemotherapy and/or hormone therapy.
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PMID:[Molecular mechanism and potential targets for bone metastasis]. 1722 Jun 61

Bone metastasis is in 60-84% of a metastatic cancer case. Bone metastasis itself does not cause a pain by all means, but even if bone metastasis contributes to 40% of cancer pain, it is said, and it is an important subject of a cancer pain treatment. Because it is a lot progressive as well as an unbearable pain, bone metastasis becomes cause by the fact that the pain is remarkable and inhibits QOL of the patient. On this account that a treatment of bone metastatic pain merely takes a pain by pharmacotherapy. Preventing pathologic fracture and a complication such as spinal cord compression and a treatment of hypercalcemia are important. In addition, we do surgical treatment and radiation therapy for the fracture that occurred positively and must deal generally.
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PMID:[Symptom with bone metastasis--bone pain, fracture, hypercalcemia]. 1723 19

Multiple myeloma is a tumor of terminally differentiated plasma cells that home to and expand in the bone marrow. It is the second most common hematologic malignancy, with approximately 16,000 new cases per year, and accounts for an estimated 11,000 deaths in the USA. It is the most common cancer to metastasize to bone, with up to 90% of patients developing bone lesions. The bone lesions are purely osteolytic in nature, and up to 60% of patients develop a pathologic fracture over the course of their disease. Bone disease is a hallmark of multiple myeloma, and the bone disease differs from other bone metastasis caused by other tumors. Although both myeloma and other osteolytic metastasis induce increased osteoclastic bone resorption, in contrast to other tumors, osteoblast activity in myeloma is either severely decreased or absent. The basis for this severe imbalance between increased osteoclastic bone resorption and decreased bone formation resulting from suppressed osteoblastic activity has been a topic of extensive investigation during the last several years. The clinical consequences of this extensive accelerated and imbalanced bone destruction process include bone pain, pathologic fractures, hypercalcemia and spinal cord compression syndromes, which can be devastating for patients and significantly impact overall quality of life and expected survival. In this chapter, we will discuss the pathophysiology underlying bone disease in myeloma. This results from the uncoupling of bone remodeling and is characterized by markedly increased activity of osteoclasts and profound decreased activity of osteoblasts. In addition, we also review the emerging data on novel targeted therapies aimed at ameliorating myeloma bone disease.
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PMID:Pathophysiology of myeloma bone disease. 1807 Jul 9

There are a variety of treatments for patients with bone metastases from breast cancer. These include bisphosphonates, antitumor endocrine and cytotoxic systemic therapies, radiotherapy to the metastatic site, radionucleotides, and conservative treatment (analgesics). The optimal combination treatment for bone metastases is not clear. Bisphosphonates are effective for reducing skeletal complications such as bone pain, pathological fracture, bone surgery, and hypercalcemia. Bisphosphonates are recommended as the gold standard therapy for breast cancer with bone metastases. Treatment guidelines tend to recommend starting a bisphosphonate at the time of diagnosis of bone metastases. Animal models have supported the prevention of bone metastasis by bisphosphonate therapy, but three major adjuvant clinical trials of the oral bisphosphonate clodronate have yielded conflicting results. However, our preliminary trial of an intravenous bisphosphonate, pamidronate, showed effective inhibition of bone metastases. The use of bisphosphonates, especially zoledronic acid, as adjuvant therapy is promising, but it is still investigational.
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PMID:Treatment of breast cancer with bone metastasis: bisphosphonate treatment - current and future. 1830 15

Bone is the most common site of metastases in patients with advanced breast cancer. In these patients, the primary aim of therapy is to prevent and delay the occurrence of skeletal-related events (SREs), which can be defined as follows: (1) pain requiring radiation or surgical intervention, (2) spinal cord compression, (3) pathologic fracture, or (4) hypercalcemia. Unfortunately, determining which patients are at highest risk for an SRE is difficult with current imaging techniques. In contrast, the urinary biomarker of bone resorption, collagen N-telopeptide, is under intensive study after repeat validation as a rapid and reliable predictor of SREs as well as prognosis and survival. Herein, we review this new role of collagen N-telopeptide as a predictor of bone involvement and response to treatment, and of the palliative benefit of bisphosphonate therapy in patients with metastatic breast cancer.
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PMID:Urinary N-telopeptide is a rapid predictor of response to and palliative benefit from bisphosphonate therapy in patients with metastatic breast cancer. 1863 15


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