Bone and soft tissue tumours: non-surgical management

Abstract

The majority of patients with a malignant bone lesion will have bone metastases from a distant primary tumour. This could be present at the time of diagnosis of malignancy or develop later in the course of the disease. Some primary tumour types are more likely than others to develop bone secondaries. This common clinical problem requires a multidisciplinary approach in order to reduce skeletal events and symptoms for patients, and maintain their quality of life. Almost all patients with metastatic bone disease will have incurable cancer and this needs to be acknowledged when considering treatment options. Conversely primary malignant bone tumours are relatively rare conditions that need to be managed by specialist centres, often requiring intensive multimodality, multi-professional treatment. Patients with localized disease can be cured but there remains a high risk of both local recurrence and metastases. Soft tissue sarcomas will often require radiotherapy and surgical treatment as primary management. Chemotherapy plays more of a role when treating metastatic disease.