Secondary cancer in the bone

This information is about cancer that has spread from the part of the body where it started, called its primary site, to the bone.

Sometimes cells break away from the primary cancer and are carried by the blood stream to another part of the body. The cancer cells settle in this new place and may form another tumour. This can be in the bone. This new cancer is called a secondary cancer or metastasis.

Not all secondary cancers cause symptoms or problems. Any type of cancer can spread to the bone but the most common ones to do this are breast, prostate, lung, thyroid, kidney and melanoma.

Symptoms of secondary cancer in the bone

Bone pain – often it is a dull, persistent ache that gets worse at night. If you have this type of pain and it lasts for one to two weeks, let your doctor know.

Weakened bones – a bone that breaks with little or no force (pathological fracture).

Raised calcium levels in the blood (hypercalcae­mia) – this can make you feel tired, sick (nauseated), constipated, thirsty or confused.

Pressure on the nerves in the spinal cord – if the bone cancer affects the bones in the spine it can cause pain, muscle weakness, and tingling or numbness of the limbs.

In the lower spine, pressure can affect the nerves to the bladder and bowel. If this is not treated quickly there is a risk of paralysis.

It is very important to tell your doctor if you have these symptoms.

How secondary cancer in the bone is diagnosed

  • Blood tests to check your calcium levels
  • Chest X-ray
  • Bone X-ray (Which does not always show bone cancer.)
  • Bone scan – uses a mildly radioactive substance injected into a vein. Abnormal bone absorbs this and shows as ‘hot spots’ on the scan. (This does show arthritis as well as cancer in the bone.)
  • CT scan – the initials CT stand for computerised tomography. CT scanners produce a specialised type of X-ray, which builds up a three-dimensional picture of the inside of the body.
  • MRI scan – a scan that uses magnetic resonance to detect abnormalities.
  • PET – the initials PET stand for positron emission tomography. The test involves having an injection of a glucose (sugar) solution containing a tiny dose of radioactive material. Using the signals from this radioactive injection, a scanning machine can build up a picture of the part of the body.
  • biopsy – a needle biopsy to take a small sample of bone to look at under a microscope.

Treatment for secondary bone cancer

The aim of treatment is to:

  • relieve symptoms
  • reduce the number of cancer cells
  • reduce the risk of a fractured bone
    • lower the risk of hypercalcaemia
    • relieve spinal cord compression.

The types of treatment used are:

  • painkillers given to reduce pain
  • radiation treatment, which is given to relieve symptoms. It is very effective on bone pain, and to relieve the symptoms of bone compression. Radiation can be given as external beam or as a radioisotope: a radioactive liquid given as a drip or injection into a vein.

Depending on the type of cancer you have you may be offered:

  • chemotherapy
  • hormonal therapy
  • bisphosphonates (bone strengthening drugs)
  • steroids (high doses of steroids used to relieve pressure, for example, in the spine)
  • surgery (sometimes surgery is used to strengthen a weaken bone).

People with secondary bone cancer can feel very tired. The Cancer Society has an Information Sheet “Cancer-Related Fatigue” which explains cancer-relat­ed fatigue and its causes. Some practical suggestions for managing fatigue are offered. To receive a copy, contact your local Cancer Society or read it online at the web address at the bottom of this page.

Helpful resources for more information

The Cancer Society offers a range of support and information services to assist those diagnosed with secondary cancer in the bone. Phone the Cancer Information Helpline 0800 CANCER (226 237) to speak to our cancer information nurses.

Suggested reading and websites

Cancer Society libraries have these books to borrow. Phone 0800 CANCER (226 237) to request them.

Reading

  • American Cancer Society. Quick Facts. Advanced Cancer. USA: American Cancer Society, 2008.
  • American Cancer Society. Quick Facts. Bone Metastasis. USA: American Cancer Society, 2008.
  • Holland, Jimmie, and Lewis, Sheldon. The Human Side of Cancer: Living with hope, coping with uncertainty. USA: HarperCollins, 2000.
  • Lynn, Joanne, and Harrold, Joan. Handbook for Mortals: Guidance for people living with serious illness. USA: Oxford University Press, 1999.
  • Moore, Thomas. Care of the Soul: A guide for celebrating depth and sacredness in everyday life. USA: HarperPerennial,1994.
  • Shinoda Bolen, Jean. Close to the Bone: Life-threatening illness and the search for meaning. USA: Touchstone Books, 1998.

Websites

This information was written in October 2010 by the Cancer Society. It is reviewed every three years.

For cancer information and support phone 0800 CANCER (226 237).