Secondary bone cancer

Blood tests

You will have a full blood count and your calcium levels will be checked.

X-rays

X-ray scans will be taken of your chest and bones to check for bone damage, the formation of new bone or fractures.

Bone scan

You will have a small amount of radioactive dye injected into a vein that will show any abnormal changes using a scanning machine.

CT or MRI scans

Scans, including three-dimensional imagery, create pictures of your body that help to highlight any bone abnormality. The scans generally take between 30 and 90 minutes.

PET scan

In a positron emission tomography (PET) scan, you will have a small amount of radioactive glucose injected into the body, which highlights any cancerous areas.

Bone biopsy

A biopsy is when some cells and tissues are removed for examination under a microscope. There are two biopsy methods.

Core needle biopsy

A thin needle is inserted under CT guidance to remove a sample of bone. This is done under local anaesthetic.

Surgical biopsy

A surgeon removes a small section of the bone. This is done under general anaesthetic.

Hormone therapy

Hormone or endocrine therapy may be used to treat prostate or breast cancer that has spread to the bone. Hormone therapy aims to lower the levels of hormones in the body or to stop hormones reaching cancer cells that need hormones to grow. It can be given as tablets or by injection.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells or slow their growth. The drugs are usually given via an injection into the vein (intravenously) over several hours. You will generally have several treatment cycles with periods of rest in between. The number of sessions will vary depending on the combination of drugs prescribed.

Targeted therapy

Targeted therapy uses drugs that attack specific features of cancer cells to stop the cancer growing and spreading. Targeted therapy can only be used to treat cancers that grow in response to certain proteins in our cells. The drugs can be given orally (by mouth), as an injection under the skin or into the vein.

Immunotherapy

Immunotherapy aims to stimulate the body’s own immune system to attack the cancer most often by using checkpoint inhibitor drugs. Some cancers create ‘checkpoints’ which block the immune system so the checkpoint inhibitors allow the immune system to bypass these checkpoints. There are several checkpoint inhibitor drugs used to treat lung cancer that has spread to the bone and clinical trials are testing checkpoint immunotherapy for other types of cancer.

Radiation therapy (radiotherapy)

Radiation therapy (radiotherapy) uses targeted radiation, usually x-rays, to kill or damage cancer cells. It is also used to reduce pain in the bone.

The most common type of radiation therapy used for secondary bone cancer is external beam radiation therapy (EBRT). You may have one radiation therapy treatment, or several over a few weeks.

Surgery

As cancer can weaken a bone and cause fracture, surgery may be used to insert metal rods, plates, screws, wires or pins. You may also have surgery if the cancer is pressing on the spinal cord.

Vertebroplasty

You may have an injection of bone cement into the bones if the cancer is causing severe back pain or damage to the bones in the spine. This is called a vertebroplasty and helps to strengthen and stabilise the bones. It usually takes about an hour.

Palliative care

As secondary bone cancer is an advanced cancer your doctor may discuss palliative treatment. Palliative care aims to improve your quality of life by alleviating symptoms of cancer, without aiming to cure it. As well as slowing the spread of the cancer, palliative treatment can relieve pain and help manage other symptoms.