ABSTRACT
This chapter considers all the patient's symptoms and all the information available to doctors and assesses the symptoms, signs and information given using this to choose the appropriate remedies for the problem and offers extra information where available and appropriate. Breast tumours are by far the most common tumours that produce osteolytic lesions and weakness or fracture of the bones. Breast cancer accounts for nearly half of the fractures seen in cancer patients. It is important to realise that bone pain is poorly responsive to morphine. In metastatic bone disease the tumour cells often produce a high local concentration of prostaglandins. Both the patient and their family need to be made aware that surgery for metastatic bone disease is not expected to prolong life or be in any way curative. It is a palliative procedure intended to control symptoms. When bone pain is present due to bone metastases, the possibility of hypercalcaemia must always be considered.
