Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
I think this is a suitable setting to ask a basic question about the
use of bisphosphonates in patients with bone metastases.
Several studies reported an improvement in "skeletal related events" (SRE)
in patients treated with bisphophonates, but I find it quite peculiar that
SRE include not only complications such as fractures, but also further
treatments such as radiotherapy to the bones (see for example the paper by
Rosen et Al. in J Clin Oncol 2003, 21:3150).
Is it correct to consider together a complication of disease and its