Managing the symptoms of secondary bone cancer

Symptoms of secondary bone cancer include pain, pressure on the nerves in the spine (spinal cord compression) a raised level of calcium in the blood and effects on the bone marrow.

Painkillers can help to control pain. Radiotherapy, bisphosphonates and surgery may also be given.

Symptoms of pressure on the nerves in the spinal cord include:

  • back or neck pain
  • weakness in the arms or legs
  • numbness or strange sensations around your body
  • problems controlling or passing urine
  • problems with your bowels.

Tell your doctor straight away if you notice these symptoms. You will need treatment as soon as possible to reduce the pressure on the spine. You may have steroids, radiotherapy or surgery.

High level of calcium in the blood can make you feel sick, thirsty, drowsy or confused and unwell. Treatment can help reduce your calcium levels.

If the bone marrow is affected it can lower the number of healthy blood cells produced. Depending on which cells are affected, you may need a blood transfusion, antibiotics or a platelet transfusion.

It is important to tell your doctor or nurse about any symptoms you have.

Managing the symptoms

Managing the symptoms of secondary bone cancer is an important part of your treatment. Symptoms of secondary cancer in the bone include:

  • pain
  • problems with daily activities
  • spinal cord compression (pressure on the nerves in the spine)
  • raised blood calcium level (hypercalcaemia)
  • effects on the bone marrow.


Pain

Pain is the most common symptom of secondary bone cancer. There are different types of pain and they may need different treatments. There are many painkillers available to treat different types and levels of pain. They are usually very effective. Painkillers may be given alone or alongside other treatments.

Your doctor or specialist nurse will discuss your pain with you. It is important to let them know if it’s not controlled or if it’s happening with everyday tasks such as walking or lifting things.

You may need to try a few different painkillers before you find one that works well for you. Sometimes, you may need to take a combination of painkillers to control the pain well.

You may have other treatments to help relieve pain. These include:

If your pain is stopping you from sleeping, your doctor may prescribe a mild sleeping tablet for you.

Other ways of relaxing and helping to reduce your pain include:

  • downloading a relaxation app or listening to relaxation CDs
  • a long soak in a warm bath
  • having a massage to an area of the body that is not painful, such as the head, hands or feet.

You can ask your doctor to refer you to a palliative care nurse. They are specialists in advising on pain and symptom control, and giving emotional support. They can visit you at home.

We have more information in our booklets Managing cancer pain and Managing the symptoms of cancer.

Managing pain during advanced cancer

Oncologist Sarah Slater explains how painkillers help people with advanced cancer.

About our cancer information videos

Managing pain during advanced cancer

Oncologist Sarah Slater explains how painkillers help people with advanced cancer.

About our cancer information videos


Walking and moving

Some people with secondary cancer in the bone may have difficulty with walking or moving around. This does not affect everyone, but may be more likely if you have pain when you move. If you have pain when you move, you doctor will want to check that the bones have not become weakened by the cancer.

If the bone does not need an operation, a physiotherapist can assess you to see if a walking stick or zimmer frame may help. They can also see what can help you move around easier at home.

If the secondary bone cancer is affecting your arms, sometimes day to day tasks can be painful or difficult. For example eating, shaving or drying your hair. If this is the case, your doctor will assess you to check whether any treatment with radiotherapy or surgery may help.

An occupational therapist can look at what may make things easier for you. They may suggest different ways to do things, or equipment that can help you to continue doing the things you want to do.


Spinal cord compression

A common place for a secondary bone cancer is the spine. This often causes back or neck pain. If this affects you, your doctors will make sure you have painkillers to relieve any discomfort.

Less often, the cancer can cause pressure on the nerves in the spine, known as spinal cord compression. Symptoms of spinal cord compression include:

  • back or neck pain, which may be mild at first but becomes severe
  • weakness in the arms or legs
  • numbness or strange sensations in your legs, hands or around your bottom and genitals
  • problems controlling or passing urine
  • constipation or problems controlling your bowels.

If you develop any of these symptoms, it is very important to let your doctor or specialist nurse know straight away. If you have spinal cord compression, you will need treatment as soon as possible. The treatment will aim to relieve the pressure and prevent permanent damage to the nerves, which could cause paralysis.

Your doctor will give you high doses of steroids to reduce the swelling and pressure around the spine. This is often followed by radiotherapy to shrink the cancer and reduce the pressure. Some people may have surgery to relieve pain and strengthen the spine. They will gradually reduce the dose of steroids after radiotherapy or surgery.


Raised blood calcium level (hypercalcaemia)

Secondary cancer cells in the bone can cause calcium to be released from the bones into the blood. High levels of calcium in the blood (hypercalcaemia) can make you:

  • sick
  • thirsty
  • drowsy
  • confused and unwell
  • constipated.

You may need to spend a few days in hospital having treatment to reduce your calcium levels.

Your doctor or nurse may ask you to drink lots of liquids. You are also likely to have a drip (intravenous infusion) of fluids into a vein in your arm. This will increase the amount of fluid in your blood, and help your kidneys to get rid of the calcium in your urine.

Your doctor may give you bisphosphonates through a drip to reduce the level of calcium in the bloodstream. You can have this treatment more than once if the calcium levels rise again. You should feel much better within a couple of days.


Effects on the bone marrow

The bone marrow is the spongy material in the centre of some of our bones. It produces our blood cells. If you have secondary cancer in the bone, this may affect how the bone marrow works and may lower the number of cells in your blood.

If you have a low level of red blood cells (anaemia), you may be breathless and get tired more easily. Your doctor may suggest that you have a blood transfusion. You can have further blood transfusions if it is helpful.

Low levels of white blood cells may make you more likely to get an infection. Your doctor can prescribe antibiotics if you do.

A low platelet count will increase your risk of bruising and bleeding. Occasionally, if your platelet count is very low, you may need a platelet transfusion.

Your doctor may suggest other types of treatment that target the cancer to help reduce the effects on the bone marrow. This will depend on which type of primary cancer you have.

We have more information about blood and platelet transfusion, and avoiding infection.