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In medicine current knowledge must be constantly reviewed as a prerequisite to making progress. This is essential both for clinicians and their patients, and it allows non-specialists to see how clinical practice is changing. Cancer is a rapidly evolving field and there have been some major advances in the treatement of associated bone metastases. Bisphosphonates have been one of the most innovative developments in this area, and clinical experience with these compounds is steadily increasing. At present, the main use of bisphosphonates is for the treatment of tumour-induced osteolysis, with or without tumour-induced hypercalcaemia and it is timely to review opinion for a wider audience. This volume comprises the proceedings of a symposium held in December 1993 in Windsor. It discusses some important developments in scientific and clinical research in oncology, including: increasing knowledge of bone metabolism and the pathophysiology of bone metastases; pharmacology of the bisphosphonates; and current experience of treating patients with bone metastases from breast cancer and other malignancies. The importance of osteoclast activation in skeletal metasases is well recognized, as is the inhibition of such activity with bisphosphonates. In the future, such treatment may also prove useful in delaying or preventing the onset of bone destruction.
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