The challenges of managing patients who present with metastatic bone disease and how this can be supported through a multidisciplinary network

Metastatic disease of the appendicular skeleton is fast becoming a major problem affecting a vast majority of the cancer population and has an increasingly significant impact on our health economics. The treatment of patients with metastatic disease has evolved over the last 50 years in order to meet these challenges in a more patient centred approach. The lack of awareness and recognition of the management options available ultimately delays referral to a specialist team and can have detrimental effects on the patient quality of life and outcomes. The challenges oftentimes cannot be met by one person alone and are best addressed by a specialised team of health care professionals making important, evidence based treatment decisions within a dedicated Multi-disciplinary Team (MDT) setting. Treatment options are tailored to meet the needs of the individual patient whilst respecting key oncologic principles. We must be aware of; 1) crucial concepts surrounding the management of patients with metastatic disease, 2) the change in thought process overtime and 3) the argument for an MDT approach, which we believe is paramount in order to improve outcomes. We must raise awareness of patients who present with metastatic disease to primary and secondary care settings, emphasising the need for early diagnosis & referral, thus decreasing time to intervention.