A number of different types of treatment can be used to treat people with secondary bone cancer. The treatment you have will depend on:

• which bone is affected
• where the cancer first started (the primary cancer)
• how damaged and weakened the bone is
• how the cancer is affecting you – the symptoms you have.

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
• lower the risk of developing a bone fracture
• reduce the risk of developing a high calcium level in the blood (hypercalcaemia).

Apart from painkillers and other pain relieving drugs, the main treatment used to relieve symptoms is radiotherapy. 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.

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

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

To treat the cancer you may be offered:

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

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 the treatment. No medical treatment can be given without your consent. Before you are asked to sign the form you should have been given full information about:

• the type and extent of the 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 don’t understand what you have been told, let the staff know straight away so that they can explain it again. Some cancer treatments are complex, so it’s not unusual for people to need repeated explanations.

It’s often a good idea to have a friend or relative with you when the treatment is explained. This can help you remember the discussion more fully.

Patients often feel that hospital staff are too busy to answer their questions, but it’s 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’s first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It is important to tell a doctor or your nurse if you decide not to have treatment, 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 give you the best advice.

Usually a number of cancer specialists work together as a team and they use national treatment guidelines to decide on the most suitable treatment for a patient. Even so, you may want to have another medical opinion. Either your specialist, or your GP, should be willing to refer you to another specialist for a second opinion, if you feel it will be helpful.

Getting a second opinion may cause a delay in the start of your treatment, so you and your doctor need to be confident that it will give you useful information. If you do go for a second opinion, it may be a good idea to take a friend or relative with you, and have a list of questions ready so that you can make sure your concerns are covered during the discussion.