Osteotropic cancers: From primary tumor to bone

It has long been recognized that primary cancers spread to distant organs with characteristic preference. Bone metastases occur in similar to 70% of patients with advanced breast and prostate cancer, causing severe morbidity and hospitalization. In the last decade, we have gained a better understanding of the mechanisms by which certain tumor types tend to metastasize specifically to bone. It appears that the interaction between the organ micro-environment and cancer cells is fundamental for establishing metastatic growth. Accordingly, Stephen Paget's 'seed and soil' hypothesis - stating that circulating cancer cells (the 'seeds') disperse in all directions, but can accomplish metastases only in organs where the microenvironment (the 'soil') is permissive for their growth - still holds forth today. For this review uses the 'seed and soil' hypothesis as a template to discuss novel this reason, insight and developments in the bone metastasis field. (C) 2008 Elsevier Ireland Ltd. All rights reserved.