Pathophysiology of Bone Metastases

Research output: Chapter in Book/Report/Conference proceedingChapter


Bone metastases are a late event in tumor progression, contributing to morbidity and mortality and decreasing patient quality of life. Cancer colonization of the skeleton is characteristic of advanced tumors of breast, prostate and other sites and of multiple myeloma. The pathophysiology of cancer in the skeleton can be conceptualized as a vicious cycle, where cancer-secreted factors activate bone cells to release factors that encourage further growth of tumor, which in turn secretes more factors into the microenvironment. Bone provides unusual physical conditions favorable to tumor growth: low pH and oxygen tension and high concentrations of calcium, phosphate and many growth factors. It also houses stem cells, bone marrow and immune cells, which can encourage the establishment, growth and survival of metastases. A plethora of bone and tumor factors contributes to the vicious cycle: too many to be individually targeted in the clinic. However, inhibition of bone resorption is invariably effective and may oppose the initial development of cancer in bone. Central pathways, such as hypoxia and TGFβ signaling, are important for both tumor and bone functions; they are promising targets for improved therapies, while other pathways may yield future treatments to decrease bone metastases and myeloma bone disease.

Original languageEnglish (US)
Title of host publicationBone Metastases
Subtitle of host publicationA translational and Clinical Approach
EditorsVassilios Vassiliou, Edward Chow, Dimitrios Kardamakis
Number of pages15
StatePublished - Mar 4 2014

Publication series

NameCancer Metastasis - Biology and Treatment
ISSN (Print)1568-2102


  • Bone metastasis
  • Bone resorption
  • Multiple myeloma
  • Osteoblast
  • Osteoclast
  • Osteocyte
  • Vicious cycle

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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  • Cite this

    Chirgwin, J. M., & Roodman, G. D. (2014). Pathophysiology of Bone Metastases. In V. Vassiliou, E. Chow, & D. Kardamakis (Eds.), Bone Metastases: A translational and Clinical Approach (1 ed., pp. 3-17). (Cancer Metastasis - Biology and Treatment; Vol. 21, No. 1).