Managing symptoms of secondary breast cancer

The symptoms of secondary breast cancer may improve with cancer treatment. Sometimes this works quickly and you may notice an improvement within a few days. But sometimes it may take a few weeks before you feel better.

There are also lots of other ways to control and manage symptoms. Always tell your cancer doctor or specialist nurse if you have new symptoms or if your symptoms get worse.

Sometimes you may be referred to a doctor or nurse who is an expert in treating pain and other symptoms. They are sometimes called supportive or palliative care specialists.

There are different symptoms, and many of them depend on where the cancer has spread to. You will not get all the symptoms we mention. Sometimes you may have very few symptoms.


Feeling very tired is called fatigue. It is common. If it is caused by the cancer, treatments may help improve tiredness. You are likely to be tired during treatment, especially if you are having chemotherapy. But this should slowly improve once you finish chemotherapy.

If you are having ongoing treatment and are struggling with fatigue, tell your cancer doctor. They may suggest adjusting the dose of your treatment, if it they think it may help.

Make sure you get enough rest. But try to balance this with some physical activity, such as short walks.

Sometimes tiredness is caused by a low number of red blood cells. This is called anaemia. Your doctor can do a blood test to check this. They may give you tablets to treat it. You may need to have a blood transfusion.

We have more information about managing fatigue.

Feeling sick

There are different types of anti-sickness drugs that can help. You usually take them as tablets. But you can also have them as a skin patch, an injection into the skin or sometimes as a suppository (into the back passage). Remember to:

  • take your anti-sickness drugs as prescribed – usually about 20 to 30 minutes before meals
  • tell your cancer doctor or specialist nurse if the drug you are taking is not working so they can prescribe a different one.


This can be caused by:

  • cancer treatment drugs, for example chemotherapy
  • anti-sickness drugs
  • painkillers.

Your cancer doctor or GP can prescribe a medicine called a laxative to help. Things you can do to help are:

  • eating more fibre
  • drinking plenty of fluids
  • being more physically active if you can – for example going for short, regular walks.

We have more information on managing constipation.

Lymphoedema (swelling of the arm)

You may develop lymphoedema as a result of treatment such as surgery or radiotherapy to the armpit. It can also happen because the cancer is blocking lymph nodes in the armpit. There are ways of reducing the swelling and managing lymphoedema. These include:

  • wearing a special sleeve
  • massage
  • bandaging your arm.

If you notice any swelling in your arm or hand, tell your cancer doctor or specialist nurse as soon as possible. They may refer you to a lymphoedema specialist.


There are many different painkillers. The painkiller you have will depend on the type of pain you have. You may need more than 1 type of painkiller.

You usually have painkillers as tablets. You can also have them as a skin patch, an injection into the skin, or sometimes as a suppository (into the back passage).

It is important to:

  • take your painkillers regularly – this will help give you constant pain control
  • let your cancer doctor or specialist nurse know if the painkillers are not controlling your pain.

Radiotherapy works well in treating bone pain if the cancer has spread to the bones. Bone-strengthening drugs can help to reduce bone pain.

Steroids are used to reduce swelling and control pain. We have more information about controlling pain.

Treating bone pain

If breast cancer has spread to the bones and is causing pain, there are different ways it can be controlled. You may be given:

  • drugs called non-steroidal anti-inflammatory drugs (NSAIDs)
  • bone-strengthening drugs called bisphosphonates or denosumab
  • a single session or short course of radiotherapy.

Radiotherapy is very effective at treating bone pain but can take a few weeks to work. Take your painkillers regularly until the radiotherapy works.

Treating bone problems

Sometimes secondary breast cancer in the bone may cause pain or other problems that need treatment. There are different ways in which bone symptoms can be managed.

Strengthening a weakened bone

If there is a risk of a bone breaking, your doctor may advise having surgery to strengthen or repair the bone. This is usually done under a general anaesthetic. You may have radiotherapy before or after surgery. This can help repair the bone and treat the cancer cells in the area.

Too much calcium in the blood (hypercalcaemia)

Secondary cancer in the bone can cause calcium to go from the damaged bone into the blood. This is called hypercalcaemia. If you have high levels of calcium in the blood, you may:

  • feel very tired and thirsty
  • pass lots of urine (pee)
  • have constipation
  • eel sick
  • be irritable and confused.

Tell your cancer doctor or specialist nurse straight away if you have these symptoms. They will give you a drip (infusion) of fluids to flush the extra calcium from your body. They will also give you bisphosphonates as a drip to lower the calcium levels. Your symptoms should go away within 2 days.

Spinal cord compression

Spinal cord compression is not common, but it is very important that it is diagnosed quickly. It can happen when the tumour is close to, or pressing on, the spinal cord and nerves.

It can happen as a first symptom of cancer. But it can also appear in people treated for early breast cancer in the past. Sometimes it can appear in people treated for breast cancer many years ago. It can happen if the breast cancer comes back and has spread to the bones in the spine.

It is important to tell your cancer doctor or specialist nurse straight away if you have any of the following symptoms. They will arrange an urgent scan to check your spinal cord.

Symptoms of spinal cord compression include:

  • unexplained pain in your back, neck, or down your arm or legs
  • pain that may feel like a tight band around the body
  • numbness or pins and needles in your arms, legs, toes, fingers, chest, back, tummy or buttocks
  • weakness in your arms or legs
  • unsteadiness or difficulty walking
  • problems controlling your bladder or bowel.

The earlier treatment starts, the more likely it is to be effective. Steroids, radiotherapy and surgery may all be used, depending on your situation. Your doctor or specialist nurse will give you more information. We have more information about spinal cord compression.


There are different things that can cause breathlessness. Tell your cancer doctor or specialist nurse if you feel breathless. They will check what is causing your breathlessness. They may arrange some tests or scans. They will give you advice on how to manage your breathlessness, and they may give you some medicines to help.

Sitting down when you are doing daily tasks such as washing, dressing or making food can help you to manage breathlessness. Controlled breathing or relaxation techniques may also help.

Pleural effusion

If cancer cells spread to the tissues that line the lungs (the pleura), it can cause fluid to build up. This is called a pleural effusion. It can make you breathless.

Your cancer doctor can treat this by passing a narrow tube into the chest to drain off the fluid. This usually improves your breathing straight away. If it comes back, the fluid can usually be drained again. It may be possible to have a special catheter put in. This allows you to drain the fluid into a bottle when you are at home.

Treating the cancer may also help to slow down or stop the fluid building up again.


To stop fluid build-up, your doctor may recommend a treatment that seals the 2 layers of the pleura together. This is called a pleurodesis. You will need to have a short stay in hospital.

During a pleurodesis you have a tube put into the chest to drain the fluid. The doctor injects sterile talcum powder through the same tube. This helps seal the layers of the pleura together.

A pleurodesis can also be done using a procedure called video-assisted thoracoscopic surgery (VATS). We have more information about pleurodesis.

Build-up of fluid in the tummy (ascites)

Ascites is a build-up of fluid between the 2 layers of the membrane that lines the tummy (abdomen). This membrane is called the peritoneum.

Ascites can be caused by cancer that has spread to the liver or to the peritoneum. Ascites causes the tummy to swell, which can make you feel full, breathless or sick.

To manage ascites, doctors usually make a small cut in the tummy and insert a tube to drain the fluid. This will quickly improve your symptoms. You can have it done again if the fluid builds up again. It may be possible to have a longer-term drain put in. This allows you to drain the fluid while you are at home.

Treating the cancer may also help to slow down or stop the fluid building up again.

Treating symptoms of a secondary brain tumour

A secondary brain tumour can cause different symptoms. These may include headaches, sickness, vision problems or weakness in an area of the body. These can be frightening, but the symptoms may often be controlled with:

Radiotherapy can often improve symptoms quickly. You can also have drugs to treat headaches or to control fits (seizures) if needed.

Complementary therapies

Some people find using certain complementary therapies alongside their medical treatments helps them to feel better. This may include:

  • relaxation therapies
  • visualisation
  • yoga.

Some complementary therapies may help reduce treatment side effects or symptoms. They may also make you feel less anxious.

Always tell your cancer doctor if you are planning to start any complementary therapies. This includes taking supplements or other medicines. This is because some complementary therapies may interact with chemotherapy or other treatments.

About our information

  • References

    Below is a sample of the sources used in our secondary breast cancer information. If you would like more information about the sources we use, please contact us at

    National Institute for Health and Clinical Excellence (NICE). Advanced breast cancer: diagnosis and treatment. Clinical Guideline [CG81]. Updated 2017. Available from: (accessed November 2021).

    BMJ best practice. Metastatic breast cancer. Available from: (accessed November 2021).

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Dr Rebecca Roylance, Consultant Medical Oncologist and Professor Mike Dixon, Professor of Surgery and Consultant Breast Surgeon.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

  • use plain English
  • explain medical words
  • use short sentences
  • use illustrations to explain text
  • structure the information clearly
  • make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.

Date reviewed

Reviewed: 01 July 2023
Next review: 01 July 2026
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

Our cancer information meets the PIF TICK quality mark.

This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.