Painful bone metastases – Can we do better?

The treatment of painful osseous metastases (POM) remains extremely challenging for the clinician. Richard Payne and Nora Janjan recognized how complex these patients are and as a result they recommended setting up specialized interdisciplinary cancer center bone metastasis clinics specific for patients with painful osseous metastases (1). Despite advances in the understanding of the pathophysiology of POM, new and improved analgesics/analgesic techniques, and a greater appreciation of how to approach the evaluation and management of patients with POM, it appears that a significant proportion of patients with POM continue to suffer.