Treatment overview for secondary bone cancer

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.

Relieving symptoms

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, as 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.

Treating the primary cancer

Treatments used to treat 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. This is because the secondary cancer cells in the bone have come from the original primary cancer, so will usually respond to the same type of treatment. You may be offered:

Reducing the risk of fractures and hypercalcaemia

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 hypercalcaemia, and to relieve pain.

Some people may have a surgery to strengthen or to remove and replace a weakened bone.

Treatment choices

If two treatments are equally effective for the type of cancer you have, your doctors may offer you a choice. Before you decide what is right for you, you might want to ask more about:

  • what each treatment involves
  • possible side effects.

Make a list of the questions you want to ask and take a relative or close friend with you. You may also find it helpful to take notes about what has been said.

Giving consent

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.

No medical treatment can be given without your consent.

Before you are asked to sign the form you should be given full information about:

  • the type and extent of the treatment
  • its advantages and disadvantages
  • any significant risks or side effects
  • any other treatments that may be available.

If you do not understand what you have been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it is not unusual to need repeated explanations.

It is a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion.

You may also find it useful to write a list of questions before your appointment.

People sometimes feel that hospital staff are too busy to answer their questions, but it is important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.

You can always ask for more time if you feel that you can't make a decision when your treatment is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. It is essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You do not have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.

The benefits and disadvantages of treatment

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 cancer in the bone, 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.

Back to Decisions about treatment