Diagnosis of secondary bone cancer
Secondary bone cancer is sometimes found at the same time as the primary cancer. It can also be found months or years after the primary cancer has been treated.
Sometimes, secondary bone cancer is diagnosed before the primary cancer is found and sometimes the primary cancer cannot be found. When tests can’t find where the cancer started, this is known as cancer of unknown primary (CUP). CUP can occur in other parts of the body as well as in the bone.
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If your doctor is concerned the cancer has spread to the bones, you may have some of the following tests:
|blood tests||including a full blood count and a check of your calcium levels|
|bone x-ray||a scan of the chest and bones to show bone damage, fractures or creation of new bone|
|bone scan||a small amount of radioactive dye is injected into a vein; it collects in the bone and any abnormal changes are found by a special camera and computer|
|CT or MRI scans||a special computer is used to scan and create cross-sectional pictures to highlight any bone abnormality; these scans take between 30 and 90 minutes|
|PET–CT scan||this is a PET scan combined with a CT scan, which provides more detailed information than CT on its own; you are injected with a small amount of radioactive glucose solution to highlight any cancerous areas on the scan|
|bone biopsy||removal of some cells and tissue from the affected bone for examination under a microscope. The biopsy may be done in one of two ways. In a core needle biopsy, a local anaesthetic numbs the area, then a thin needle is inserted to remove a sample of bone. The doctor may use a CT scan to help guide the needle into the bone. In a surgical biopsy, a surgeon removes a small section of bone. This is done under a general anaesthetic.|
Prognosis means the expected outcome of a disease. You may want to discuss your prognosis and treatment options with your doctor.
Factors that affect prognosis include whether the cancer has spread to other parts of your body, how quickly it is growing and how it responds to treatment. It is not possible for anyone to predict the exact course of the disease, but your doctor can provide you with general information on the expected outcomes of people in a similar situation to you.
Secondary bone cancer can’t be cured, but treatment can reduce symptoms and improve quality of life. In some cases, treatment can keep secondary bone cancer under control for many years.
Dr Craig Lewis, Conjoint Associate Professor UNSW, Senior Staff Specialist, Department of Medical Oncology, Prince of Wales Hospital, NSW; Dr Katherine Allsopp, Staff Specialist, Palliative Medicine, Westmead Hospital, NSW; Michael Coulson, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; David Phelps, Consumer; Juliane Samara, Nurse Practitioner Specialist Palliative Care, Clare Holland House, Calvary Public Hospital Bruce, ACT; A/Prof Robert Smee, Radiation Oncologist, Nelune Cancer Centre, Prince of Wales Hospital, NSW.
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