The most common symptom of secondary bone cancer is pain in the affected area. The pain may be a dull, persistent ache that often gets worse at night when the muscles are relaxed. There may also be swelling and tenderness in the area.

If you develop this type of pain and it lasts for more than one to two weeks, it is a good idea to let your doctor know as soon as possible. Although bone secondaries can occur in several different bones at the same time, usually only one or two areas are painful.

Sometimes if a bone is weakened by cancer it will fracture or break, even if you have not had an accident or fall. This is known as a pathological fracture.

When bones are affected by secondary cancer cells, increased amounts of calcium (the substance that helps to build bones) may be released into the blood. A raised level of calcium in the blood is called hypercalcaemia. It can cause symptoms such as tiredness, feeling sick (nausea), constipation, thirst and confusion.

However, in many people hypercalcaemia is discovered during a blood test, before any symptoms develop.

If secondary bone cancer affects the bones of the spine it can put pressure on the nerves in the spinal cord. This is called spinal cord compression and may cause symptoms such as pain, muscle weakness and sometimes tingling and numbness of the limbs.

If the lower spine is affected, it may also affect how the bowel and bladder work. If you have weakness, pain, tingling or numbness in the legs it is very important to let your doctor know as soon as possible so that effective treatment can be given.

Sometimes secondary cancer in the bone can make you feel more tired (fatigued) than usual.

Occasionally secondary cancer in the bone can affect the way that the bone marrow works. The bone marrow is the spongy material that fills the bones and produces blood cells.

The different types of blood cells are:

• red cells, which carry oxygen around the body
• white cells, which help to fight infection
• platelets, which help the blood to clot and prevent bleeding.

If the bone marrow is unable to produce enough blood cells you may become anaemic. This can mean that you are more likely to get infections or to have bruising or bleeding.