With multiple myeloma or bone metastases comes the risk of skeletal-related events (SREs).

Without early detection, the consequences of those SREs can be devastating.

video1

Dr. Anil Kapoor and Dr. Alan So open up about counselling patients on the risk of SREs.

video2

Dr. Wendy Lam discusses how fractures can affect a patient’s quality of life.

video3

Dr. Andrew Loblaw and Dr. Neil Fleshner cover the importance of early bone health evaluation.

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The risk:
Who gets SREs and
when do they occur?


Bone metastases occur
in up to:
Bone lesions occur in up to:

90%

90% of men with advanced prostate cancer1

75%

75% of patients with advanced breast cancer2

40%

40% of patients with advanced lung cancer2


Bone lesions occur
in up to:

100%

100% of patients with multiple myeloma2

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In one study,* SREs were seen at
diagnosis of bone mets in:3

Within 24 months, the incidence
of SREs increased by more than:3

10%
of prostate cancer patients
4x
in prostate cancer patients
22%
of breast cancer patients
2x
in breast cancer patients
22%
of lung cancer patients
2x
in lung cancer patients
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The reality:
What SREs are common and
what complications can they
cause?


SREs may manifest in
various forms, such as:4–5

They can cause a range of potentially
devastating complications, including:4–8

Pathological fractures

  • Severe pain
  • Disability and loss of function
  • Reduced load-bearing capabilities

Spinal cord compression

  • Paralysis
  • Urinary retention/incontinence
  • Impotence

Radiation to the bone

  • Anorexia and fatigue
  • Myelosuppression
  • Vomiting and diarrhea

Surgery to the bone

  • Wound infection
  • Gastric bleeding
  • Risk of reoperation
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Your role:
Why does bone health matter and
how can you help your patients?

With cancer patients increasingly living longer,11
their quality of life is becoming increasingly important.


Assess your patient’s bone health before SREs occur,
using the below recommendations as a guide.

In prostate cancer patients, screen for bone mets using bone scans at a recommended frequency of:1

  • Every 3 to 6 months in patients with a rapid PSADT (<10 months).

  • Every 6 to 12 months in patients with a slower PSADT (>10 months).

– CUA-CUOG CRPC Guidelines


In breast cancer patients, screen for bone mets in:12

  • All patients with recurrent/Stage IV disease, using a bone scan or sodium fluoride PET/CT, as well as radiographs of any long or weight-bearing bones that are painful or appear abnormal on bone scan.

  • All other patients presenting with localized bone pain or elevated alkaline phosphatase, using a bone scan.

– NCCN Breast Cancer Guidelines


In patients with suspected multiple myeloma, screen for osteolytic bone lesions using:13

  • Whole-body imaging with low-dose CT or FDG PET/CT, as part of the diagnostic work-up.

  • Skeletal survey in certain circumstances.

  • Whole-body MRI without contrast, if initial CT or FDG PET/CT is negative.

– NCCN Multiple Myeloma Guidelines

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Cancer took so much.
Don’t let SREs take what’s left.

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