Bone Cancer Forum - Secondary Bone Cancer Treatments

Secondary bone cancer can be treated effectively although it cannot be cured in the long term. The aim is to relieve your symptoms and improve your quality of life by controlling the growth of the cancer.

The treatment you are offered will depend on your symptoms, how far the cancer has spread in the bones (or elsewhere within the body), whether or not you’ve had your menopause, the type of tumour you had originally, treatments you've had in the past and your general health.

* Hormone therapies are generally used to treat cancers that are sensitive to oestrogen. There are several different types so you can try another if you've had them before or if you're taking one that has stopped working
* Chemotherapy. If your secondary bone cancer doesn't respond to hormone treatment (or has stopped responding to it) you may be offered chemotherapy. A number of chemotherapy drugs are used to treat secondary bone cancer. These drugs may be given alone or in combination. Secondary bone cancer can be slow to respond to chemotherapy and you may need several cycles with three or four weeks between them.
* Radiotherapy. The aim of radiation treatment is to shrink the tumour and so reduce pain (which improves your mobility) and prevent possible fractures. Radiotherapy for secondary bone cancer can be given as a single dose or divided doses over a few days. This means that the side effects are likely to be minimal. Radiotherapy is usually given only once to the affected area.
* Radioisotopes is another way of giving radiotherapy. The radioisotope is in liquid form and is given as an injection into the vein. The radioisotope travels through the bloodstream and delivers radiotherapy to the bones affected by the cancer cells. It's sometimes useful when there are several areas of secondary bone cancer throughout the body, although it‘s not commonly used for secondary bone cancer from the breast.
* Bisphosphonates are drugs that target the parts of the body where there is high bone turnover (the areas where the osteoclasts have become overactive). They do not treat the cancer itself but may help to reduce the breakdown of the bone by restricting the action of the osteoclasts. They can be given in tablet form, through a drip or by an injection into a vein. They are given for three reasons:

• to reduce high calcium levels in the blood

• to reduce pain that has not responded well to painkillers or is too widespread for local radiotherapy

• long-term use of bisphosphonates reduces the risk of bone fractures and may delay the spread of the secondary bone cancer.

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Monoclonal antibodies. This is a group of drugs sometimes used to treat secondary breast cancer. One example is Herceptin (trastuzumab). Only 25-30% of breast cancers are eligible to be treated with this drug (known as HER2 positive breast cancer). To find out whether it's an option for you a test would be done on breast tissue removed from your original surgery.
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If the secondary bone cancer is causing severe back pain and damage to the bones in the spine you may be able to have an injection of bone cement into the bones to strengthen them and relieve pain. This is called a vertebroplasty and is done in the x-ray department. It takes about one hour and you can usually go home later that day.