| [ Summary ] |
Cancer directly or indirectly affects bone metabolism and environments. As a direct effect, cancer colonizing bone disrupts the balance of bone remodeling by increasing osteoclastic bone resorption and decreasing osteoblastic bone formation, thereby causing intractable bone pain and skeletal-related events including pathologic fractures and nerve compression syndromes. As an indirect effect, cancer at primary site secretes a variety of circulating endocrine factors such as parathyroid hormone-related proteins and fibroblast growth factor-23 that influence bone metabolism and calcium/phosphate metabolism, thereby inducing paraneoplastic syndromes including hypercalcemia and oncogenic hypophosphatemic osteomalacia. Earlier and timely detection and treatment of bone metastasis or paraneoplastic syndromes are critical to the improvement of quality of life and survival in cancer patients. Furthermore, study on bone metastasis and paraneoplastic syndromes may deepen our insights on the mechanism underlying cancer progression. |