Prognosis of
pancreatic cancer is one of the worst among various
cancers, however, incidence of bone
metastasis has been increased even in
pancreatic cancer in recent years. Therefore, we examined clinical features of
pancreatic cancer presenting bone
metastases who were treated in our
cancer center, and propose how to manage these patients. We experienced 13 patients (7.3%) with
pancreatic cancer with bone
metastases during 2000-2003. Among these patients,
pancreatic cancer was located at pancreatic body to tail in 10 cases, while it was located at pancreatic head in 3 cases. Liver
metastasis was noted in 7 of 13 cases with bone
metastases. Radiographical imagings of bone lesions revealed osteolytic bone destruction, and serum levels of
bone resorption marker, 1CTP, were elevated in these patients. Stimulation of osteoclastic
bone resorption is a critical step for bone
metastasis, thus, serum levels of
cytokines (
PTHrP, IL-6,
VEGF), which exert a promotive effect on
bone resorption, were measured. Serum levels of
IL-6 and
VEGF were elevated in most of these patients, while elevation of serum
PTHrP levels was found in 3 of 13 patients with bone
metastases. Survival periods of
pancreatic cancer patients with bone
metastases was not long, however, treatment for bone
metastases is important in terms of quality of life (QOL). An earlier diagnosis is essential to prevent deterioration in the QOL of
pancreatic cancer patients presenting bone
metastases. Periodical measurement of serum 1CTP in addition to bone scintigraphy is helpful for the earlier diagnosis for bone
metastases.