Treatment for secondary bone cancer
A number of different types of treatment can be used to treat people with secondary bone cancer.
The aim of treatment is to:
relieve any symptoms, such as bone pain, and make you feel more comfortable
reduce the number of cancer cells by treating the primary cancer
reduce the risk of developing a bone fracture or a high calcium level in the blood (hypercalcaemia).
Treatment is not normally given with an aim to cure the cancer, although many people live with secondary bone cancer for a long time.
Radiotherapy is the main treatment used to relieve bone pain and make you feel more comfortable.
This may be given by a machine (similar to an x-ray machine) as external beam radiotherapy (often known just as external radiotherapy). It may also be given as internal radiotherapy using a radioisotope (a radioactive liquid). Radioisotopes may be given by injection, as a drip into a vein or by mouth.
Treating the primary cancer
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Treating the primary cancer will help reduce the number of cancer cells and may also reduce symptoms. The type of treatment you’ll have will depend on where your cancer started.
This is because the secondary cancer cells in the bone have come from your original primary cancer, and will usually respond to the same type of treatment as the primary cancer. You may be offered:
Reducing the risk of fractures and hypercalcaemia
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Bisphosphonates (bone-strengthening drugs) may be used to reduce the risk of fracture or hypercalcaemia, and to relieve pain.
Sometimes surgery may also be carried out to strengthen a weakened bone.
How treatment is planned
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In most hospitals, a team of specialists will talk to you about the treatment they feel is best for your situation.
This multidisciplinary team (MDT) will include:
an oncologist - a specialist in cancer treatments such as hormonal therapy, chemotherapy, radiotherapy and targeted therapy
a nurse specialist, who gives you information and support.
It may also include other healthcare professionals, such as a surgeon who specialises in bone cancers, a palliative care (symptom control) specialist, a dietitian, a physiotherapist, an occupational therapist, and a psychologist or counsellor.
The MDT will take a number of factors into account when advising you on the best course of action, including your general health, where the cancer started (the primary tumour) and which bones are affected.
If two treatments are equally effective for the type and stage of cancer you have, your doctors may offer you a choice. If you have to decide between treatments, make sure that you have enough information about the different options.
You might want to ask more about what is involved in each treatment, and about possible side effects, before you decide what is right for you. It often helps to make a list of the questions you want to ask and to take a relative or close friend with you. You may also find it helpful when discussing treatment options to take notes about what is said.
Your multidisciplinary team (MDT) uses national treatment guidelines to decide the most suitable treatment for you.
Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you, and have a list of questions ready, so that you can make sure your concerns are covered during the discussion.
Before you have any treatment, your doctor will explain its aims.
They will usually ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should be given full information about:
the type and extent of the treatment
its advantages and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away, so they can explain again.
Some cancer treatments are complex, so it’s not unusual to need repeated explanations.
It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.
People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.
You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.