Comment: The Detection of Occult Metastatic Cancer by Radioactive Bone Scans

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Abstract
The ability to detect occult metastases at the time of initial appearance of the primary tumor is of major importance in the management of the patient with cancer. Prostate cancer is a particularly suitable example in discussion of this problem; it shares the same role in the male as breast cancer has in the female, accounting for 60% to 70% of all bone metastases.42The majority of patients with prostate cancer have either occult or detectable osseous involvement at the time of first diagnosis. The effect of such knowledge on making decisions or on treating the primary cancer by radical surgery, radical radiation therapy, and/or hormonal manipulation can be profound. The unique importance of acid phosphatase has been discussed; however, elevation of levels of this enzyme fails to distinguish local extracapsular spread from metastatic cancer. The value of radioisotope scans in detecting occult metastatic bone cancer has received increasing

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