Metastatic bone disease is a major healthcare issue, affecting 4.9 million individuals in the United States. The cost of bone metastasis from cancer was estimated to be thirteen billion dollars per year in the United States in 20051, and the annual incident number of cancer cases in the United States is expected to double over the next fifty years. With improved medical treatment of many cancers, patients are living longer, which places them at increased risk for the development of metastatic disease3,4. The skeleton is the third most common target of metastatic cancer and can be one of the earliest sites affected, especially in individuals with breast or prostate cancer. Ultimately, 60% to 84% of all cases of metastatic disease invade bone, and approximately 70% of patients with metastatic bone disease experience bone pain. Patients with metastatic cancer involving bone are also at increased risk for fractures, spinal cord compression, hypercalcemia, and immobility resulting in substantial medical-associated morbidities.



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