Tumor-bone interactions: There is no place like bone

Cancer whether from solid tumors or in the form of hematologic malignancies frequently spreads to bone where it will disrupt the balance of bone remodeling between bone formation and resorption. Cancer patients with skeletal complications will experience severe clinical consequences affecting their quality of life, the worst of all being that cancer in bone remains incurable. As research and our understanding of these pathologies are progressing, the intricate interactions between cancer cells and bones are being revealed showing us that the affinity of cancer cells for bone is already determined in the primary tumor or how cancer cells can prepare the metastatic niche prior to colonizing the skeleton. These complex processes are regulated by multiple genes that cooperate to ensure cancer cell growth and survival, despite the treatments developed. In this chapter, we will review the mechanisms controlling the different steps leading to overt metastases and how these could be used to develop new therapies to prevent skeletal complications of malignancies or to cure cancer from bone.