Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0153690 (bone metastases)
 6,382 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this study was to determine the ability of disodium dichloromethylene diphosphonate (Cl2MDP) to reduce the hypercalcemia secondary to skeletal metastases and induced by stimulation of bone resorption by malignant cells. Five patients with hypercalcemia due to bone metastases of breast or renal cancer were treated orally for 4 wk with 3,200 mg of Cl2MDP and 4 wk with a placebo in a double blind, crossover study. During the Cl2MDP period of administration four patients experienced a rapid and significant decrease in serum calcium and urinary calcium excretion together with an increase in alkaline phosphatase. In the remaining patient who developed a sudden paraplegia at the onset of the therapy followed by a marked increase in serum calcium levels and urinary calcium excretion, Cl2MDP was able to reverse this worsening of hypercalcemia or to reduce serum and urinary calcium to normal values. For all patients, urinary hydroxyproline excretion was unchanged during the Cl2MDP period when compared with the prestudy or placebo periods. From these results, and because of the rapid relapse of hypercalcemia during the placebo period or after withdrawal of the treatment, we can conclude that Cl2MDP is capable of reducing excessive mobilization of calcium resulting from bone metastases.
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PMID:Effects of disodium dichloromethylene diphosphonate on hypercalcemia produced by bone metastases. 644 55

Ten patients with prostatic carcinoma--six with stage C and four with stage D disease--were treated for 6 weeks to 12 months with agonistic analogues of luteinizing hormone-releasing hormone (LH-RH). [D-Trp6]LH-RH was given subcutaneously once daily at a dose of 100 microgram and [D-Ser(But)6]des-GlyNH2(10)-LH-RH ethylamide (HOE 766) was given subcutaneously (50 microgram once daily) or intranasally (500 microgram twice daily). In all patients, mean plasma testosterone levels showed a 75% suppression by the third week of treatment and remained low thereafter. This was followed by a decrease or normalization of plasma acid phosphatase levels by the second month of treatment and a 47% decrease in serum alkaline phosphatase by the 10th week of treatment in all but one patient. In patients with stage C disease presenting with prostatism or urinary outflow obstruction, there was a noticeable clinical improvement. In two such patients, a decrease in the size of the prostate was confirmed by ultrasonography. In patients with stage D disease manifested by diffuse bone metastases, there was relief of bone pain, and in one patient treated for greater than 12 months the improvement was documented by radioisotope bone imaging. It is concluded that superactive agonistic LH-RH analogues hold promise as therapeutic agents in patients with androgen-sensitive prostatic adenocarcinoma. Furthermore, the analogous of LH-RH may be used to assess the responsiveness of patients to surgical castration. Long-term administration of LH-RH analogues could become an alternative to surgical castration and estrogen therapy for the treatment of hormone-dependent prostatic carcinoma.
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PMID:Tumor growth inhibition in patients with prostatic carcinoma treated with luteinizing hormone-releasing hormone agonists. 646 61

Bone scintigraphy, serum acid phosphatase activity (ACP), prostatic acid phosphatase by radioimmunoassay (PAP) and alkaline phosphatase activity (ALP) were studied in 117 consecutive patients with prostatic cancer. Serum PAP was more sensitive than ACP in indicating prostatic cancer in the 63 patients with normal bone scans: 28% had positive PAP tests and 15% positive ACP tests. In the 54 patients with bone metastases no difference in the frequency of positive PAP (84%) and ACP (85%) test was observed. Serum PAP and ACP, but not ALP, were useful for the assessment of the response to therapy particularly in patients without bone metastases. In the follow-up of patients with bone metastases the scan was more informative than any of the phosphatase assays studied.
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PMID:Bone scintigraphy and serum phosphatases in the detection and follow-up of bone metastases in prostatic cancer. 649 27

Hypercalcemia is a well-recognized phenomenon in squamous cell carcinoma of the head and neck, but the incidence of hypercalcemia in this group of patients is not clear. We have reviewed the records of 166 patients with squamous cell carcinoma of the head and neck presented at the Boston VA Medical Center over a 2-year period (October 1981 to September 1983). Hypercalcemia (greater than 11 mg/dl), for which a benign etiology could not be identified, occurred in the clinical course of seven patients (4.2%). Of the hypercalcemic patients, 5/7 (71.4%) had advanced stage IV disease and serum calcium levels ranging from 11.2 to 15 mg/dl at presentation. The incidence of hypercalcemia in this stage IV group was 5/78 (6.4%). On the basis of concomitant serum alkaline phosphatase, x-ray films, and radionuclide bone scans in these patients, bone metastases or a humoral factor were felt to be the etiologic agent. Six of the seven patients died within 77 days of the onset of the hypercalcemia despite vigorous antihypercalcemic and chemotherapeutic measures, and the remaining patient is under chemotherapy at present. We conclude that hypercalcemia is a late manifestation of advanced squamous cell carcinoma of the head and neck and is an ominous prognostic sign. Hypercalcemia without bone metastases is presumably due to the production of ectopic parathormone (PTH)-like substances from the tumor. To control this hypercalcemia, the underlying tumor must be treated vigorously in conjunction with symptomatic treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The incidence of hypercalcemia in squamous cell carcinoma of the head and neck. 651 40

Two hundred cancer patients with bone metastases were studied by gammagraphy employing 555 MBq of 99mTc-MDP. The results were compared with those obtained by radiology and alkaline phosphatase determination, showing that gammagraphy is positive in 93 per 100 of the cases and is more useful than the other procedures to make a pre-radiologic diagnosis of bone metastases (27 per 100).
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PMID:[Value of studying oncologic patients using bone gammagraphy for the diagnosis of skeletal metastasis. Review of 200 cases]. 654 32

Serum levels of osteocalcin, the major noncollagenous bone protein, are elevated in patients with certain metabolic bone diseases, but the effects of other illnesses on serum osteocalcin levels are not known. We measured serum osteocalcin concentrations in 250 patients in a rehabilitation hospital who suffered from various illnesses. Mean serum osteocalcin levels were elevated in patients with 1) recent hip fracture who required open reduction and pin insertion (mean +/- SE, 19.0 +/- 3.2 ng/ml), 2) primary (22.0 +/- 4.9 ng/ml) or secondary hyperparathyroidism (51.6 +/- 9.9 ng/ml), 3) Paget's disease of bone (22.7 +/- 6.1 ng/ml), or 4) metastatic skeletal disease who had not received therapy (37.5 +/- 11.3). Mean serum osteocalcin levels were normal in patients who had received 1) a hip prosthesis for a recent fracture or for severe degenerative joint disease of the hip (6.4 +/- 0.9 ng/ml), 2) recent chemotherapy or irradiation for bone metastases (6.1 +/- 1.3 ng/ml), or 3) a variety of medical problems not related to bone disease (5.2 +/- 0.3 ng/ml). Serum osteocalcin and alkaline phosphatase values did not correlate. This study demonstrates that serum osteocalcin levels are normal in disorders not involving bone, can be used in a general-hospital setting, where concomitant illnesses are present, and may provide additional information for the clinical evaluation of metabolic bone disease.
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PMID:Clinical evaluation of bone turnover by serum osteocalcin measurements in a hospital setting. 661 Jun 86

205 patients with solid cancer, underwent bone marrow biopsy using a Jamshidi needle, regular type. 32 (16%) biopsies were positive for bone marrow metastases. Results were correlated with those of skeletal radioisotope scans, X-ray films and the complaint of bone pain, alone or combined. 27 of 131 (17.5%) patients with positive X-ray film and 31 of 110 patients (28.1%) who complained of bone pain had a positive bone marrow biopsy. 17 of 46 (36.9%) patients with 3 positive parameters had a positive bone marrow biopsy as compared with none of 18 patients whose these 3 parameters were negative. Average values of Hb, WBC, serum alkaline phosphatase and calcium did not differ between patients with positive or negative bone marrow biopsy. 86 patients were diagnosed to have bone metastases and 35 more patients were diagnosed within a year following the biopsy. Of these 121 patients, 46 of 46 with positive scan, X-ray and pain were diagnosed to have bone metastases as compared to 27 of 30 patients with a positive scan with pain but negative X-ray film. Only 1 of 18 patients with negative parameters was diagnosed as having bone metastases within a year from biopsy. In our experience, it is of no value (unlike in malignant lymphoma and oat cell carcinoma of lung) to obtain a bone marrow biopsy for the detection of bone marrow micrometastases in asymptomatic cancer patients with negative skeletal radioisotope scan and negative bone X-ray films.
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PMID:Bone marrow biopsy in solid cancer. 681 51

Analysis of urinary hydroxyproline levels offers a marker to monitor osseous involvement in patients with metastatic malignancies. Such a marker is needed in patients with prostatic cancer when bone metastases predominate. Thirty-two men with stage D2 prostatic cancer were monitored by bone scan, acid and alkaline phosphatase values, and urinary hydroxyproline, beginning from 4 to 36 months after initiation of hormonal manipulation and/or systemic chemotherapy. In patients with disease progression determined by bone scan serial urinary hydroxyproline values progressively increased and were significantly elevated compared to urinary values obtained from patients with a stable or improving scan (p less than 0.001). Simultaneous alkaline phosphatase determinations showed less significant differences between patient groups. Acid phosphatase did not reliably indicate osseous response to therapy. These data suggest that urinary hydroxyproline values are predictive as an early objective sign of osseous response in patients receiving therapy for stage D2 prostatic cancer.
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PMID:Serial spot hydroxyproline/creatinine ratios in metastatic prostatic cancer. 683 97

Seventy-one patients with breast cancer and bone metastases, together with other assessable sites of disease, were monitored by radiologic skeletal survey, bone scanning, pain charts, bone marrow aspirate, serum calcium, alkaline phosphatase and urine hydroxyproline/creatinine ratio. On the basis of UICC criteria of response in nonosseous sites, 37 were classed as responders and 34 as nonresponders. Responding patients with osteolytic disease frequently showed sclerosis, but only at 6-8 months, whereas patients with mixed lytic/sclerotic or sclerotic metastases frequently showed no change or further sclerosis. Nonresponders most frequently showed progressive lysis. Bone scanning showed clear evidence of improvement or deterioration in 7/21 responders and 8/23 nonresponders who showed no definite evidence of progression or response on skeletal radiography. Pain assessment was also useful in these patients. Neither the bone marrow aspirate nor other biochemical tests were useful in assessing response to therapy. This study concludes that bone scanning and pain assessment are both useful in assessment of response of bone metastases to treatment in some patients and incorporation into a standard criteria of response is recommended.
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PMID:Assessment of response of bone metastases to systemic treatment in patients with breast cancer. 686 Oct 98

Although hypercalcemia is a well-known complication of malignant diseases, hypocalcemia seems to be a rather rare one. A 34-yr-old woman with advanced breast cancer who presented hypocalcemia is described. She had generalized multiple osteolytic bone metastases which were progressive in spite of chemo-endocrine and radiation therapy. She was admitted because of severe bone pain and dyspnea caused by bilateral pleural effusion. Laboratory examination on admission showed that the serum calcium was 9.6 mg/dl, serum total protein 5.9 g/dl, serum inorganic phosphorus 4.6 mg/dl, and serum alkaline phosphatase 29.6 King-Armstrong units. The serum calcium gradually fell to 7.0 mg/dl on the 45th hospital day when the serum total protein was 6.8 g/dl and she complained of paresthesia in the extremities. On the 58th day, severe tachycardia and hypotension developed and she died of congestive heart failure on the 67th hospital day. At that time the serum calcium was 5.4 mg/dl. During her hospital course, the plasma parathyroid hormone levels were examined repeatedly and were 0.4, 0.6, 0.6 and 0.7 ng/ml (normal; less than 0.5 ng/ml). Autopsy revealed that cancer invaded the space between the thyroid and the trachea and no parathyroid glands could be found even in the mediastinum. Microscopically the parathyroid glands were replaced completely by the cancer cells. These observations indicate that metastasis of breast cancer to the parathyroid glands caused relative hypoparathyroidism, resulting in hypocalcemia. In addition, congestive heart failure which was refractory to digitalis and diuretics might have been caused by impaired contractility of the myocardium associated with hypocalcemia.
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PMID:A case of advanced breast cancer associated with hypocalcemia. 688 61


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