What is secondary bone cancer?

Secondary bone cancer is when a cancer that started somewhere else in the body has spread to the bones.

Where a cancer starts is called the primary cancer. If some cancer cells break away from the primary cancer, they can move through the bloodstream or lymphatic system Open a glossary item to another part of the body forming a new tumour. This is called a secondary cancer. Secondary cancers are also called metastases (pronounced me-tass-ta-sis).

Diagram showing how cancer cells get into the blood stream and are able to spread to other parts of the body

The secondary cancer is made of the same type of cells as the primary cancer.

So, if your cancer started in your lung and has spread to your bones, the areas of cancer in the bone are made up of lung cancer cells.

This is different from having a cancer that first started in the bone (a primary bone cancer). In that case, the cancer is made up of bone cells that have become cancerous. This is important because the primary cancer tells your doctor which type of treatment you need.

This video is about secondary cancer, it lasts for 2 minutes and 42 seconds.

Which cancers spread to the bones?

Any cancer can spread to the bones. The most common ones to spread are:

  • prostate cancer
  • breast cancer
  • lung cancer
  • kidney cancer
  • thyroid cancer
  • myeloma

Secondary bone cancer can develop in any of the bones of your body. 

Diagram of the skeleton

Symptoms of secondary bone cancer

Symptoms can include:

  • pain – the pain is continuous, and people often describe it as gnawing
  • backache, which gets worse despite resting
  • breaks in the bones because they are weaker
  • dehydration, confusion, being sick, tummy (abdominal) pain and constipation due to high levels of calcium in the blood (hypercalcaemia)
  • increased risk of infection, breathlessness and looking pale, bruising and bleeding due to low levels of blood cells. Blood cells are made in the bone marrow and can be crowded out by the cancer cells
  • pain, weakness in your legs, numbness, paralysis and loss of bladder and bowel control (incontinence). This could be because of pressure on the spinal cord (spinal cord compression)

Remember that aches and pains are common and may be a muscle strain or an everyday ache. Tell your doctor if you have a new pain. They can check what is causing it and treat it as soon as possible. This helps to avoid further problems such as bone fractures or severe pain.

Contact your healthcare team straight away or go to the accident and emergency (A and E) department if you have symptoms of spinal cord compression, as it is an emergency.

Tests

There are different tests you might need to diagnose secondary bone cancer. You may have one or more of the following:

  • MRI scan
  • PET scan
  • X-rays
  • bone scan
  • CT scan
  • PET-CT scan
  • PET-MRI scan
  • bone biopsy - a small sample of bone is sent to the laboratory for a specialist doctor to look at under a microscope

Treatment

The aim of treatment for secondary cancer is usually to control the cancer and relieve symptoms. It may also help prevent problems from developing. Some people with secondary cancer may be too unwell to have treatment for the cancer.

Survival

Most people worry about their outlook (prognosis) when they have a secondary cancer. Your individual outlook depends on many factors including whether the cancer has spread to more than one part of your body, how quickly it is growing, and how it responds to treatment. It is usually difficult to predict and this uncertainty can be hard to deal with.

It is usually difficult to predict and this uncertainty can be hard to deal with. Speak to your doctor who can give you more information about your outlook.

  • Cancer: Principles and Practice of Oncology (12th edition)
    VT DeVita, TS Lawrence, SA Rosenberg
    Wolters Kluwer, 2023

  • Hypercalcaemia
    National Institute for Health and Care Excellence (NICE), August 2019

  • Percutaneous consolidation of bone metastases: strategies and techniques
    R L Cazzato and others
    Insights into Imaging, 2019. Volume 10, Issue 14, Pages 1 to 7

  • Prostate cancer: diagnosis and management
    National Institute for Health and Care Excellence (NICE), December 2021

  • Advanced breast cancer: diagnosis and treatment
    National Institute for Health and Care Excellence (NICE), August 2017

  • Mechanisms, Diagnosis and Treatment of Bone Metastases

    J Ban and others

    Cells, 2021 October  29. Volume 10, Issue 11, Page: 2944

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

Last reviewed: 
25 Aug 2023
Next review due: 
25 Aug 2026

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