Patients with metastatic spinal
tumor are the largest in number among the patients with bone
tumor. It causes a severe bone
pain,
pathological fracture and
spinal cord compression. Thus it harshly hampers patient's quality of life. We report 3 patients with
lung cancer whose initial manifestation was metastatic spinal
tumor. We treated the 3 patients with palliative
radiotherapy and medication. Although the severe
pain has improved on a numerical rating scale(NRS), but performance status(PS)and activity of daily living(
ADL)of the 3 patients got worse because the disease was progressed and complicated. Generally, PS of
cancer patients found by bone matastasis is low. However, it is difficult to take an effective treatment, which leads to
ADL improvement. There are many choices for treating metastatic bone
tumors including
pain control,
bisphosphonate administration,
radiation therapy,
strontium radiotherapy,
bone cement,
palliative surgery and orthotics. In addition, a development of molecular target drugs, such as Denosmab, is expected as future modality of
palliative care. In conclusion, we should detect a bone
metastasis in the patient with
lung cancer as early as possible, and select an appropriate treatment in collaboration with each specialist for achieving the
ADL and PS improvement.