Secondaries in the bone are common with secondary breast cancer. Find out about the treatments available.

What problems can secondaries in the bone cause?

Secondaries in the bone are common with secondary breast cancer. They can occur in any bone, but are most common near the centre of your body, such as your spine.

Bone metastases can cause:

  • Bone pain
  • Weak areas of bone, meaning you might get a broken bone or fracture
  • Pressure on your spinal cord (known as spinal cord compression) and other nerves, causing pain, numbness, movement problems, difficulty balancing and incontinence
  • Too much calcium in your blood, which can make you feel sick

Treatment may help to reduce these symptoms. You should also be able to have rehabilitation to help you lead as normal a life as possible.

Let your treatment team know right away if you get any symptoms of spinal cord compression listed above so you can be assessed promptly.

What treatments might I receive?

People with secondary breast cancer in their bones may live for a long time with anticancer drugs.

Other treatments you might receive include:

  • Bone-strengthening drugs
  • Steroids
  • Painkillers
  • Radiotherapy
  • Surgery

You may also be offered to take part in a clinical trial, find out more here.

Your treatment will be planned to:

  • Try to prevent your secondaries damaging your bones
  • Control any pain you’re experiencing
  • Treat any complications caused by your cancer

Bone-strengthening drugs

If you have secondaries in your bones, your treatment team will recommend that you take a bone-strengthening drug to help protect your bones. Bisphosphonates work by reducing the speed at which bone is broken down.

Examples are pamidronate, ibandronate and zoledronate. They can reduce your bone pain and lower the chance of you having complications, such as a bone fracture.

Another drug that can protect your bones is denosumab. The side effects of bisphosphonates differ depending on which one you take and whether it is given as a tablet or intravenously.

For example, pamidronate given intravenously can cause fever and low levels of calcium, whereas clodronate given as tablets can cause mild gastrointestinal symptoms.

Bisphosphonates can cause loss of bone in your jaw if you get an infection. Denosumab can cause low levels of calcium in your blood, skin infections and loss of bone in your jaw if you get an infection.

Let your dentist know if you’re receiving bone-strengthening drugs before you have any dental procedures, because these could increase your risk of jaw problems.

Steroids

You may be recommended steroids (also known as corticosteroids) if your tumour is putting pressure on your nerves and this is causing symptoms.

Examples are dexamethasone and prednisolone. Steroids can also help to relieve bone pain.

Painkillers

Painkillers can help to block bone pain. They can be very effective at relieving pain. The type of painkiller you’re prescribed will be tailored to treat the level of pain you have.

You can learn more about treatments for pain in our section on quality of life

Radiotherapy

Radiotherapy is treatment with radiation to kill cancer cells. It can be given as a single dose or multiple doses and can be very good for treating bone pain. Although it can be very useful, it does not work for every patient. 

There are usually few side-effects with radiotherapy, but it does depend on which bit of your body is being treated.

Your radiation or clinical oncologist can explain what side effects you might experience and the risks of radiotherapy.

Surgery

About one in six people with secondaries in the bone have surgery.

Different types of surgery that you may have include:

  • Surgery to repair or prevent bone fractures (such as in the hip or thigh bone). This might involve a pin being joined to the bone, or bone cement being injected into the weak area
  • Repairing damaged joints (such as by having a hip replacement)

Surgery to treat spinal cord compression and to strengthen the spine (such as by adding bone cement to the area affected)

Your orthopaedic surgeon can explain what side effects you might experience and the risks of surgery.

Rashpal talks about her cancer spreading to her bones, particularly her spine:

Watch our video about treating cancer in the bone:

Tips and advice

Advice on getting the best care

To help you feel confident you’re getting the best care, you may want to:

  • Ask your treatment team to explain what your treatment options are, and why they are recommending a particular drug or procedure for you
  • Ask whether an expert such as an orthopaedic surgeon can be consulted about your treatment, if they haven’t been already
  • Ask whether there are any additional options for you, including new procedures, clinical trials or treatment at other centres
  • Go over the risks and benefits of each treatment with your treatment team
  • Speak up if you get new symptoms or side effects – your treatment team can often help by prescribing additional treatment

Information Standard

Information last reviewed: October 2015

Next review due: October 2018

Breast Cancer Now's health information is covered by NHS England's Information Standard quality mark. Find out how this resource was developed