What is secondary bone cancer?

Secondary bone cancer is sometimes called bone secondaries or bone metastases. It happens when cancer cells from a primary tumour somewhere else in the body spread to the bones. For example, breast cancer cells that spread to the bone.

Secondary bone cancers can occur in any of the bones in the body. Sometimes only one area of bone is affected. But in most people the cancer will spread to a number of areas.

The most commonly affected bones are the:

  • spine
  • ribs
  • pelvis
  • upper bones of the arms (humerus) and legs (femur)
  • skull.

Myeloma is a type of blood cancer that develops from cells in the bone marrow and often affects the bones.

Any cancer type can spread to the bone. We have more information about secondary cancer. This includes cancer types that are more likely to spread to the bone. 

People who develop secondary bone cancer usually know they have a primary cancer. But sometimes, a secondary bone cancer is found before or at the same time as the primary cancer. Occasionally the primary cancer cannot be found. This is called a cancer of unknown primary.

We have separate information about primary bone cancer.

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Symptoms of secondary bone cancer

The most common symptom of secondary bone cancer is pain. The amount of pain will vary from person to person. It is important to get any symptoms you have checked out by your doctor.

We have more information about possible symptoms of secondary bone cancer.

Causes of secondary bone cancer

The cause of secondary bone cancer is always a primary cancer somewhere else in the body. We do not fully understand why some people develop secondary bone cancer and others do not.

Diagnosis of secondary bone cancer

You may see your GP or your cancer specialist to diagnose secondary bone cancer. They will ask you about any symptoms you have and may examine you.

You may have some of the following tests and scans:

  • Blood tests

    You may have a blood test to check your general health and the level of calcium in your blood.

  • Bone x-rays

    Bone x-rays can show changes in the bone such as a fracture and may show a secondary bone cancer. Not all secondary bone cancers can be seen on an x-ray.

  • Bone scan

    Bone scans how all the bones in the body. This scan is more sensitive than an x-ray and shows any abnormal areas of bone more clearly.

  • CT scan

    A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body.

  • MRI scan

    An MRI scan uses magnetism to build up a detailed picture of areas of your body.

  • PET-CT scan

    A PET-CT scan is a combination of a CT scan, which takes a series of x-rays to build up a three-dimensional picture, and a positron emission tomography (PET) scan. A PET scan uses low-dose radiation to measure the activity of cells in different parts of the body.

  • Bone sample (bone biopsy)

    A bone biopsy means the doctor takes a sample of cells from the bone to be checked for cancer under the microscope. There are different ways of doing this.

Diagnosing the primary cancer

Secondary bone cancer can occasionally be found before the primary cancer is diagnosed.

If this happens your doctor will want to know where the primary cancer is. They may arrange for you to have tests to find this out. Your doctor will be able to tell you more about these tests.

Waiting for test results can be a difficult time, we have more information that can help.

Treatment for secondary bone cancer

A team of specialists will meet to talk about the best possible treatment for you. This is called a multidisciplinary team (MDT).

The aim of treatment for secondary bone cancer is to control the cancer rather than cure it. Controlling the cancer allows many people to live with secondary bone cancer for a long time.

We have more detailed information about how secondary bone cancer is treated.

Managing the symptoms of secondary bone cancer is usually an important part of your treatment.

To relieve symptoms, you may be offered radiotherapy, painkillers or other medication. Treatments for the primary cancer may also treat the secondary cancer and help symptoms. You may be offered 1 or a combination of:

  • Hormonal therapy
    You may be offered hormonal therapies to treat secondary bone cancer from breast or prostate cancer.
  • Chemotherapy
    Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Whether chemotherapy is likely to help and which chemotherapy drugs are used depends on where in the body the primary cancer started.
  • Targeted therapy
    Targeted therapy be used to treat some types of cancer that has spread to the bone. For example a drug called denosumab may be used to help lower the risk of fractures caused by secondary bone cancer.
  • Immunotherapy
    Immunotherapy is used to treat some types of cancer. Your doctor will tell you if this is an option for you.
  • Surgery
    You may have surgery to strengthen a weakened bone, to relieve pressure on the nerves in the spinal cord or occasionally to remove a secondary cancer from a bone.
  • Bisphosphonates
    Bisphosphonates are drugs that can help to strengthen the bones. The aim of bisphosphonates is to reduce the risk of fractures or high levels of calcium in the blood (hypercalcaemia) and help with pain.

Other treatments may occasionally be used for secondary bone cancer.

Treatment for secondary bone cancer may be offered as part of a clinical trial.

After secondary bone cancer treatment

After treatment, your specialist team or GP will organise regular check-ups for you. You may also have some tests. Your specialist team will continue to monitor your symptoms and may give you further treatments if needed.

If you have any problems between appointments, contact your doctor or specialist nurse as soon as possible.

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