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 
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).
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.
A secondary cancer is a cancer that has spread from where it first started to another part of the body. You might hear people call it a metastasis, metastases or advanced cancer.
Where a cancer starts is sometimes called the primary cancer. A secondary cancer is made up of the same type of cells as the primary cancer. SO, for example a cancer that starts in the bowel may spread to the liver. The cancer cells in the liver are the same type of cells that started in the bowel.
Secondary cancers happen when cancer cells break off the primary cancer and move through the body. This can happen by cancer cells passing through the blood or the lymphatic system.
The lymphatic system is a network of tubes and glands that filters body fluid and fights infection.
The cancer cells can travel through the blood and lymphatic systems to other parts of the body. Most cancer cells die when they are moving through but some don’t and can pass through the blood and lymphatics into another part of the body. They can then grow and develop into another cancer in that part of the body.
Cancer can spread to anywhere in the body but there are places that it is more likely to spread to depending on where your cancer started. So for example bowel cancers are most likely to spread to the liver and lungs and cancers that start in the lungs is more likely to spread to the brain and bones.
Treatment will depend on where your cancer started. This is because the primary and secondary cancer cells are the same and will respond to the same types of treatment. Treatment might include one or more types. You should talk to your doctor to find out how the treatment will work. Once a cancer has spread it can be more difficult to cure.
The aim of treatment may be to control the growth of the cancer and any symptoms you have for as long as possible or sometimes the aim might be to get rid of the cancer completely.
For more information about secondary cancer go to cruk.org/secondary-cancer. For more information about your cancer type go to cruk.org/cancer-type
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.
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.
