Managing the symptoms of secondary bone cancer

Secondary bone cancer can cause unpleasant symptoms. Managing these symptoms is often an important part of your treatment.


The most common symptom is pain. Different types of pain are treated in different ways. Painkillers can help to control pain. Radiotherapy, bisphosphonates and surgery may also be given.

Spinal cord compression (pressure on the nerves in the spine)

This can cause back or neck pain, weakness in the arms or legs, numbness or strange sensations around your body, problems controlling or passing urine or problems with your bowels. Tell your doctor straight away if you notice these symptoms as you will need treatment as soon as possible to reduce the pressure on the spine. You may have steroids, radiotherapy or surgery.

Raised blood calcium level (hypercalcaemia)

This can make you feel sick, thirsty, drowsy or confused and unwell. You may need treatment in hospital to reduce your calcium levels. This could involve getting more liquid into your body or having bisphosphonates.

Effects on the bone marrow

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


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’s important to let them know if it’s not controlled.

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:

  • listening to relaxation CDs
  • a long soak in a warm bath
  • having a massage to an area of the body that isn’t painful, such as a head, hand or foot massage.

Let your doctor or specialist nurse know as soon as possible if your pain isn’t controlled.

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 about managing cancer pain and controlling 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

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 and/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’s 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 to relieve the pressure and prevent permanent damage to the nerves, which could cause paralysis.

You will be given 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. The dose of steroids will be gradually reduced 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 feel:

  • sick (nauseous)
  • thirsty
  • drowsy
  • confused and unwell.

It can also cause constipation. 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's 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.