Biology of Bone Metastases in Prostate Cancer

Advanced-stage prostate cancer (PCa) patients are often diagnosed with bone metastases. Bone metastases remain incurable and therapies are palliative. PCa cells prevalently cause osteoblastic lesions, characterized by an excess of bone formation. The prevailing concept indicates that PCa cancer cell secrete an excess of paracrine factors stimulating osteoblasts directly or indirectly, thereby leading to an excess of bone formation. The exact mechanisms by which bone formation stimulates PCa cell growth are mostly elusive. In this review, the mechanisms of PCa cancer cell osteotropism, the cancer cell-induced response within the bone marrow/bone stroma, and therapeutic stromal targets will be summarized.

The Art of Enduring Contradictory Goals: Challenges in the Institutional Co‐construction of a ‘Good Death’

This paper focuses on the normative notion of ‘good death’, its practical relevance as a frame of reference for ‘death work’ procedures in institutional elder care in Switzerland and the ways in which it may be challenged within migrant ‘dying trajectories’. In contemporary palliative care, the concept of ‘good death’ focuses on the ideal of an autonomous dying person, cared for under a specialised biomedical authority. Transferred to the nursing home context, characterised by long-term basic care for the very old under conditions of scarce resources, the notion of ‘good death’ is broken down into ready-to-use, pragmatic elements of daily routines. At the same time, nursing homes are increasingly confronted with socially and culturally diversified populations. Based on ethnographic findings, we give insight into current practices of institutional ‘death work’ and tensions arising between contradicting notions of a ‘good death’, by referring to decision-making, life-prolonging measures, notions on food/feeding and the administration of sedative painkillers.