In the United States in 1993 the American Cancer Society estimated that there were about 1,300,000 new cases of invasive cancer diagnosed. At the time of presentation about 70% of those patients represented limited local regional disease without evidences of distant dissemination. About 30% of the patients had demonstrated metastatic disease at the time of initial diagnosis or about 390,000 patients. Of those patients with local regional disease about 56% would be cured by the best treatment programs including surgery, radiation therapy with or without chemotherapy when given for cure. Therefore, of the 1,300,000 new cases of invasive cancer, about 509,000 would be cured by the best treatments available. However, about 790,000 patients will have metastatic disease as a part of initial presentation or following the completion of definitive treatment. The majority of the patients with metastatic disease will have metastases to bone as the dominant site of metastatic disease primarily from cancers of the breast and lung but other metastatic sites will be common including lung, liver, mediastinal and retro-peritoneallymph node groups as well as brain and spinal cord. It has been suggested by SMITHERS, CARLING and WINDEYER that the management of the patient with metastatic disease or recurrent disease can be a more difficult problem in management than a patient who is treated for cure.

I Prolong Life

1 Advanced Rhabdomyosarcoma of the Sinus
2 Advanced Cancer of the Hypopharynx
3 Paraplegia
4 Melanomatosis with Abnormal Cerebral Computed Tomography Scan
5 Multiple Cerebral Metastasis from Cancer of the Lung
6 Superior Vena Cava Syndrome
7 Widely Disseminated Breast Cancer and Hypercalcemia
8 Palliative Treatment of Cancer of the Pancreas (With 3 Figures)
9 Recurrent Cervical Cancer with Positive Para-aortic Nodes
II Preventive or Anticipatory Irradiation
10 Extragonadal Choriocarcinoma
11 Mammary Adenocarcinomatosis Complicated by Vertebral Destruction
12 Cord Compression
13 Advanced Locoregional Breast Cancer
14 Abnormal Cerebral Computed Tomography Scan, Status Post Lung Cancer
15 Positive Prostate Biopsy Post Irradiation
16 Metastatic Lymphoma and Spinal Cord Compression
17 Palliative Radiation in Metastatic Osteosarcoma
18 Myeloma with Disseminated Osseous Metastases
19 Rising Carcinoembryonic Antigen Levels Two Years After Postoperative Irradiation
III Re-irradiation
20 Recurrent Rectal Carcinoma Post Radiotherapy
21 Breast Cancer Re-irradiation (With 1 Figure)
22 Cauda Equina Syndrome Secondary to Lymphoma
IV Recurrence
23 Chest Wall Recurrence Post Breast Cancer Surgery
24 Aggressive Abdominal Lymphoma
25 Retroperitoneal Recurrence from Anal Canal Carcinoma
26 Pelvic Pain
27 Lumbar Pain Post Nephrectomy
28 Bone Metastases Post Breast Cancer
29 Leukemic Meningitis
30 Extensive Recurrence of Colon Carcinoma
31 Local Recurrence from Cancer of the Rectum
V Miscellaneous
32 Pelvic Pain
33 History of Lymphoma with Abnormal Magnetic Resonance Imaging
34 Palliative Radiation for Pulmonary Widespread Disease
35 Symptomatic Multiple Cerebral Lesions
36 Multiple Cancers and Diffuse Bony Metastases
37 Carcinomatous Meningitis
38 Adenocarcinoma Metastatic to the Brain
39 Craniopharyngioma
40 Metastatic Cancer Involving the Eye (With 3 Figures)
List of Contributors.