bims-rebome Biomed News
on Rehabilitation of bone metastases
Issue of 2025–07–27
six papers selected by
Alberto Selvanetti, Azienda Ospedaliera San Giovanni Addolorata



  1. Radiother Oncol. 2025 Jul 18. pii: S0167-8140(25)04552-9. [Epub ahead of print] 111048
       BACKGROUND AND PURPOSE: Skeletal-related events (SRE) are a major source of morbidity and mortality across cancer types. Identification of risk factors for SRE and association with survival would facilitate more targeted preventive treatment.
    MATERIALS AND METHODS: This retrospective cohort study included patients with bone metastases from solid tumors undergoing systemic imaging from February-March 2022 who had not received radiation within one year. Survival was analyzed using Cox models, and multi-state models assessed factors linked to SRE with death as a competing risk. Outcomes were SRE (including radiation for pain) and all-cause death. Variables included tumor type, metastasis site, and trial eligibility.
    RESULTS: Among 410 patients (median age 67 years; 48 % male), 162 (40 %) experienced SRE over a median follow-up of 26.8 months. Seventy-five (18.3 %) received radiation for pain alone. Experiencing any type of SRE (HR 1.98, 95 % CI 1.47-2.67, p < 0.001) or radiation for pain alone (HR 2.14, 95 % CI 1.57-2.92, p < 0.001) were both associated with increased mortality. Patients eligible for a trial of early radiation were more likely to develop SRE (HR 1.67, 95 % CI 1.18-2.37, p = 0.004). Prostate cancer histology (HR 1.70, p = 0.02) and metastases to the hip/acetabulum (HR 2.55, p = 0.02) were associated with SRE.
    CONCLUSION: Patients treated with radiation for pain alone demonstrated similar risk of death as those experiencing any type of SRE, supporting the inclusion of radiation in endpoint definitions. Prostate cancer type and hip/acetabulum metastasis location may help identify patients and lesions at elevated SRE risk, informing future preventive strategies.
    Keywords:  Acetabulum; Bone Neoplasms; Metastases; Morbidity; Pain; Prostatic Neoplasms; Radiation Oncology; Radiotherapy
    DOI:  https://doi.org/10.1016/j.radonc.2025.111048
  2. Cancer Pathog Ther. 2025 Jul;3(4): 280-292
      This consensus on multiple myeloma-related bone diseases (MBDs) underscores the importance of a multidisciplinary approach that encompasses hematology, radiology, orthopedics, and additional specialties to tackle its intricate challenges. MBD, a prevalent and debilitating complication of multiple myeloma, leads to bone pain, fractures, and skeletal-related events (SREs), which profoundly impact patients' quality of life. The guidelines offer a thorough framework for diagnosis, treatment, and continual assessment, emphasizing early detection and consistent monitoring using imaging techniques such as positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI). Treatment strategies prioritize the careful application of anti-myeloma agents, bisphosphonates, and denosumab to minimize bone loss and decrease SRE risk, complemented by surgical and radiotherapy interventions for structural or pain-related issues. Supportive care measures, including pain management, rehabilitation, nutritional support, and dental evaluations, play a crucial role in enhancing patient outcomes and preserving quality of life. This consensus advocates a standardized, evidence-based approach to managing MBD, ensuring comprehensive and coordinated care for patients.
    Keywords:  Bone disease; Diphosphonates; Multiple myeloma; Orthopedics; Quality of life; Recommendation; Therapeutic effect
    DOI:  https://doi.org/10.1016/j.cpt.2024.12.002
  3. Asia Pac J Oncol Nurs. 2025 Dec;12 100748
       Objective: Cancer cachexia is highly prevalent in digestive and head and neck cancer patients who often face mechanical eating difficulties and metabolic disturbances. However, terminological and diagnostic ambiguities surround cachexia, limiting the evaluation of the effects of management interventions for these patients. Whole-body exercise plays a key role in mitigating weight and muscle mass losses. This scoping review provides an updated synthesis of the effects of exercise interventions and offers practical guidelines for patients with digestive or head and neck cancers experiencing undernutrition, anorexia, sarcopenia, and/or cachexia.
    Methods: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, a systematic search of the published literature was carried out in the PubMed, Google Scholar, and EBSCOhost databases. Studies eligible for inclusion investigated the feasibility and effects of whole-body exercise interventions in digestive or head and neck cancer patients with altered nutritional status. The findings from each study were tabulated and synthesized according to the type of exercise intervention.
    Results: Twenty-six full texts out of 603 studies met the inclusion criteria, encompassing a total of 1936 patients participated (mean age: 63.80 ​± ​6.22 years; 822 [31.62%] women). Exercise interventions did not result in adverse outcomes. The most assessed parameters included functional and aerobic capacity, muscle strength, body weight, quality of life, and physical activity levels, with findings ranging from positive effects and trends to non-significant changes. Interventions incorporating endurance exercises demonstrated greater improvements in functional and aerobic capacity compared to those focusing solely on resistance training. Supervised interventions yielded the most significant improvements.
    Conclusions: Exercise interventions are safe and feasible for patients with digestive and head and neck cancers identified as suffering from undernutrition, anorexia, sarcopenia, and/or cachexia. Future research should focus on tailoring exercise characteristics to achieve greatest benefits in patients with cachexia. Studies should also explore real-life implementation strategies to optimize patient engagement and adherence while accommodating medical and personal constraints.
    Systematic review registration: CRD42024602857.
    Keywords:  Cachexia; Cancer of digestive system; Exercise; Muscle mass; Sarcopenia
    DOI:  https://doi.org/10.1016/j.apjon.2025.100748
  4. Support Care Cancer. 2025 Jul 19. 33(8): 703
       PURPOSE: While metastatic bone disease (MBD) and multiple myeloma (MM) are two distinct conditions, both can cause destructive bone lesions which increase the risk of pathologic fractures. This fear of fractures and bone pain can influence a person's attitudes toward physical activity (PA). The objective of this study was to identify the attitudes and needs related to PA among individuals with MBD and MM.
    METHODS: A phenomenological qualitative study utilizing a pragmatic approach to thematic analysis within a patient-oriented research framework was utilized. Semi-structured interview questions and thematic analysis using the 7-stage Framework Method were utilized.
    RESULTS: Twenty volunteers (90% male) with MBD (n = 16, 80%) and MM (n = 4, 20%) diagnosed within 2-66 months of the study participated. Half did not report any bone pain, with none experiencing severe bone pain and eight (40%) experiencing pain specifically with movement. Most engaged in physical activities of various intensities, although 25% were considered sedentary. The majority of participants recognized the value of PA as a contributor to their health and QoL. Five major themes emerged from the interviews including "Meaning of PA," "Support for PA in Cancer," "Motivators to engage in PA," "Barriers causing a reduction in PA post diagnosis," and "PA program preferences."
    CONCLUSION: Individuals with MBD and MM want and do engage in regular PA, although differences in the frequency and intensity exist. While there is no "one-size-fits-all" approach, those with MBD and MM are interested in some form of exercise program as part of their cancer care. Supporting these individuals to surmount their PA barriers is essential for them to reap the comprehensive benefits of PA encompassing all aspects of well-being.
    Keywords:  Cancer; Exercise prescription; Metastatic bone disease; Multiple myeloma; Physical activity
    DOI:  https://doi.org/10.1007/s00520-025-09701-5
  5. Curr Issues Mol Biol. 2025 May 20. pii: 374. [Epub ahead of print]47(5):
      Cancer is a major global health issue, and exercise has become a key supportive treatment. It contributes to reducing cancer risk, enhancing prognosis, and aiding recovery, especially for survivors. However, the exact mechanisms, such as how exercise reduces cancer risk or enhances treatment, are still unclear. Current research often focuses on specific cancer types, ignoring the diverse needs of patients. This limits the development of personalized exercise plans. Additionally, there is insufficient comparison of exercise types-like aerobic, resistance, and high-intensity interval training-regarding their adverse effects and long-term benefits. The best combination of exercises and personalized strategies remains unknown. This review underscores the contribution of physical exercise to cancer prevention and treatment, emphasizing its positive effects on reducing fatigue, improving physical strength, and enhancing mental health. It also explores the molecular mechanisms of regulating tumor immunity and energy metabolism. Additionally, the article covers criteria for selecting exercise types and intensities, and the development of personalized exercise plans. Finally, it provides guidelines for exercise prescriptions and suggests future research directions to improve interventions for cancer patients.
    Keywords:  cancer patients; exercise; exercise prescription; physical activity
    DOI:  https://doi.org/10.3390/cimb47050374
  6. Endocr Pract. 2025 Jul 16. pii: S1530-891X(25)00968-1. [Epub ahead of print]
       OBJECTIVES: Thyroid cancer (TC) is the most common endocrine malignancy, and bone metastasis (BM) is the second most common type of metastasis after lung metastasis. BM is associated with a poor prognosis; however, relevant research remains limited. This study aims to evaluate the prognostic factors and survival outcomes in patients with thyroid cancer with bone metastasis (TCBM).
    METHODS: Data from patients with thyroid cancer with bone metastasis were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariable and multivariable Cox proportional hazards regression models were used to identify survival predictors. Survival outcomes were calculated using the Kaplan-Meier method and compared using the log-rank tests.
    RESULTS: A total of 696 TCBM patients from 2010 to 2021 were included in this study. For the TCBM patients, those age ≥55 years (P < 0.001); those with anaplastic thyroid cancer (P < 0.001); those with brain, liver and lung metastases (all P < 0.05); and those with T4 stage disease (P = 0.011) exhibited significantly worse overall survival (OS), with radioisotope therapy (P < 0.001) significantly improved OS. Additionally, significant factors for cancer-specific survival (CSS) included ATC (P < 0.001); liver and lung metastases (all P < 0.001); and radioisotope treatment (P < 0.001).
    CONCLUSION: Our study revealed the critical role of age, pathological subtype, metastatic lesions, and radioisotope therapy in determining the prognosis of TCBM. These findings contribute to providing more rational treatment decisions and risk stratification for TCBM patients.
    Keywords:  Bone metastasis; Differentiated thyroid cancer; SEER database; Survival; Thyroid cancer
    DOI:  https://doi.org/10.1016/j.eprac.2025.07.010