Abstract

Skeletal complications are frequently linked to patients with advanced cancer who have metastatic bone disease. These can be crippling, resulting in pain, reduced quality of life, and decreased survival rates. This review looks at ways to minimize the significant burden that metastatic bone pain can place on affected patients by optimizing management. Despite the availability of numerous treatment options, cancer-related pain is notoriously undertreated and underreported. Analgesics other than opioids can be used. The latter are typically given in conjunction with radiotherapy, which is the current treatment of choice for patients who are experiencing pain in metastatic bone. In some complicated cases of metastatic bone disease, surgery may be necessary, but other options like radiopharmaceuticals may provide additional relief. Collectively known as bone-targeted agents (BTAs); denosumab and bisphosphonates) can provide additional pain relief. All patients with metastatic bone disease should start treatment with BTAs because these drugs delay not only the onset of skeletal-related events but also the onset of bone pain. The potential for individualized care for these patients is further enhanced by the emergence of evidence for the pain-relieving properties of new anticancer medications.

Physicians’ thorough understanding of the potential synergistic benefits and drawbacks of the various agents is essential to optimizing care. In the holistic approach to cancer pain management, appropriate anti-tumor treatment, early initiation of BTAs, and adequate analgesia may lessen the debilitating effects of metastatic bone pain.