Find out about the different treatment options for secondary bone cancer. We also have information about the benefits and disadvantages of treatment.
Treatment for secondary bone cancer usually aims to:
- relieve any symptoms, such as bone pain, and to improve your quality of life
- treat the cancer that is affecting the bone
- reduce the risk of a bone fracture or a high calcium level in the blood (hypercalcaemia).
Treatment is normally given with the aim of controlling the cancer rather than curing it. However, many people live with secondary bone cancer for a long time.
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.
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT). 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.
You may be offered treatment as part of a clinical trial.
Managing symptoms is usually an important part of treatment for secondary bone cancer.
Radiotherapy may be used to relieve bone pain and make you feel more comfortable. This may be given using a machine similar to an x-ray machine. This is called external beam radiotherapy. You may also have internal radiotherapy using a radioisotope (a radioactive liquid). This may be given by injection, as a drip into a vein, or by mouth.
Other treatments to relieve symptoms may include painkillers and other medications.
Treatments for the primary cancer may also treat the secondary cancer and help relieve symptoms.
The type of treatment you have will depend on where your cancer started. Secondary cancer usually responds to the same type of treatment that you have for the primary cancer. You may be offered one or a combination of:
- Hormonal therapy
Hormonal therapy is usually used for secondary bone cancer that has spread from breast or prostate cancer.
Whether chemotherapy is likely to help and which chemotherapy drugs are used depends on where in the body the primary cancer started. For example, if you have breast cancer that has spread to the bones, you will have chemotherapy drugs that are used to treat breast cancer.
- Targeted therapy
Targeted therapy is often used to treat kidney cancer that has spread to other parts of the body, including the bones. They are also sometimes used to treat other cancers that have spread, such as prostate, breast and lung cancer.
Immunotherapy is used to treat some types of cancer. If this is an option for you, your doctor will talk to you about it.
Surgery may be used to help strengthen a weakened bone, relieve pressure on the nerves in the spinal cord or occasionally to remove a secondary cancer from a bone.
Your doctor may offer you drugs called bisphosphonates or a drug called denosumab. These are bone-strengthening drugs. They are used to reduce the risk of fractures or high blood calcium (hypercalcaemia), and to relieve pain.
Some people may have an operation to strengthen or to remove and replace a weakened bone.
Other treatments that may occasionally be used for secondary bone cancer include:
- high intensity focused ultrasound, which uses high-frequency focused sound waves to heat and destroy cancer cells
- radiofrequency ablation, which uses heat to destroy cancer cells
- cryotherapy, which uses very cold temperatures to destroy cancer cells.
These treatments are not widely available and you may have to travel to another hospital to have them.
Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. However, these can usually be controlled with medicines. Treatment can be given for different reasons and the potential benefits will vary depending upon your individual situation.
For people with secondary bone cancer, treatment usually aims to control the cancer. This can lead to an improvement in symptoms and a better quality of life. However, for some people, the treatment will have no effect on the cancer, and they get the side effects with little benefit.
Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment.
If you choose not to have treatment, you will still be given supportive (palliative) care, with medicines to control any symptoms.