The aim of treatment for a secondary bone cancer is to:

• relieve any symptoms and make you more comfortable
• reduce the number of cancer cells
• reduce the risk of developing a fracture of a bone
• reduce the risk of developing a high calcium level in the blood (hypercalcaemia).

Apart from painkillers, the main treatment used to relieve symptoms is radiotherapy given to the affected area of the bone. The radiotherapy may be given by a machine (similar to an x ray machine) as external beam radiotherapy or as a radioisotope. A radioisotope is a radioactive liquid, usually given as an injection or by a drip into a vein.

To treat the underlying cancer you may be offered:

• chemotherapy
• hormonal therapy
• a combination of hormonal therapy and chemotherapy.

The type of treatment you have will depend on where your cancer started. This is because the secondary cancer cells in the bone have come from the primary cancer site and will usually respond to the same type of treatment as the primary cancer.

Bisphosphonates (bone strengthening drugs) may be used to reduce the risk of fracture or hypercalcaemia.

Before you have any treatment, your doctor will explain the aims of the treatment to you. You will usually be asked to sign a form saying that you give your permission (consent) for the hospital staff to give you treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should be given full information about:

• the type and extent of treatment you are advised to have
• the advantages and disadvantages of the treatment
• any other treatments that may be available
• any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.

Patients often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. It is essential to tell a doctor, or the nurse in charge, so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it can be helpful to let the staff know your concerns so that they can discuss them with you and give you the best advice.

It is often a good idea to have a friend or relative with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before you go for your appointment.