About treatment

Advanced bladder cancer can sometimes spread to your bones. It can cause pain and weaken them. When the bones are weaker they can break more easily.

Some drug treatments can help to strengthen your bones and prevent problems.


Denosumab is a type of targeted cancer drug called a monoclonal antibody. It helps to strengthen the bones, which lowers the risk of your bone breaking (fracture) and helps to control pain.

You have denosumab as an injection under your skin (subcutaneously).


Bisphosphonates are another type of drug treatment that helps to strengthen bones. They have other benefits like preventing and slowing down bone thinning (osteoporosis). They can also help treat high calcium levels in your blood.

There are several different types of bisphosphonate, including:

  • disodium pamidronate (Aredia)
  • ibandronic acid or ibandronate (Bondronat)
  • sodium clodronate (Bonefos, Clasteon, Loron)
  • zoledronic acid or zoledronate (Zometa)

You can have them by a drip into your bloodstream or as tablets to take at home.

More information about secondary bone cancer

Coping with secondary bone cancer can be difficult. Understanding more about it and getting the help and support you and your family need can help you cope. 

  • Efficacy and safety of denosumab versus zoledronic acid in delaying skeletal-related events in patients with gastrointestinal cancer, pancreas-biliary system cancer, and other rare cancers
    H Imai and others
    Journal of Bone Oncology, 2017. Volume 6, Pages 37 – 40

  • Bladder cancer: diagnosis and management 
    National Institute for Health and Care Excellence, 2015

  • Treatment of Bone Metastases in Urologic Malignancies
    M Froehner and others
    Urologia Internationalis, 2014. Volume 93. Pages 249 – 256

  • EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer
    J A Witjes and others
    European Association of Urology, 2017

Last reviewed: 
01 Jul 2019

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