Bone Cancer Secondary Symptoms

Recognizing bone metastasis symptoms is important for anyone who has cancer. Bone metastasis is a complication of cancer and an indication that the cancer has moved from another area of the body into the bones.

Any cancer can spread to the bones, but the ones most likely to do so are breast, prostate, kidney, lung and thyroid cancers. Breast cancer metastasis to bone is common.

Bone metastasis is also called secondary bone cancer and is a different condition from primary bone cancer, which starts in the bones.

Secondary Bone Cancer Symptoms

Bone pain is usually the first of the bone metastasis complications to appear. According to the American Cancer Society (2010), the bone pain often comes and goes at first and tends to be worse at night. The American Academy of Orthopaedic Surgeons (2007) recommends that anyone with cancer who experiences any pain, especially in the back, legs and arms, tell their doctor immediately.

Bone metastases, also called bone mets, can either make the bone weak, causing broken bones and large amounts of calcium being released into the blood, or it can make the bones harder, a condition called sclerosis.

As bones become weak and deteriorate, they release calcium into the bloodstream. High calcium can cause a number of symptoms. Early symptoms may include:

  • Constipation
  • Excess thirst and drinking large amounts of fluid
  • Frequent urination
  • Sluggishness or sleepiness.

High calcium (hypercalcemia) can also cause confusion, muscle weakness and muscle and joint aches. If left untreated long enough, high calcium levels can cause kidney failure or coma. The first treatments for hypercalcemia are usually fluids and bisphosphonate drugs. If they don’t work, other drugs are available.

If the bone cancer is in the bones of the back, bone metastasis complications can include pressure on the spinal cord, which is a painful, serious problem. The pressure can damage the spinal cord, causing numbness or even paralysis in the arms and legs. Because nerves from the spinal cord control the bladder, the first symptom of pressure on the spine is usually difficulty with urinating.

Diagnosis of Bone Metastasis

If you have bone metastasis symptoms, one way that your healthcare provider tests you for metastasis to bone is with a blood test to check the amount of an enzyme called alkaline phosphatase. Bone cancer often increases the levels of alkaline phosphatase in your blood. However, growing children and people with fractured bones that are healing also have a high level of this enzyme.

Another blood test can check for high calcium levels, but elevated levels can also result from other medical conditions.

Usually, a healthcare provider uses imaging tests such as X-rays, bone scans, computerized axial tomography (CT) scan, magnetic resonance imaging (MRI) or positron emission tomography (PET) to check for bone mets.

If the imaging and lab results are unclear, the next step in diagnosis is usually a bone marrow aspiration and/or a bone biopsy. In a bone marrow aspiration, the doctor inserts a needle into the center of a bone and removes a bone marrow sample. In a bone biopsy, the doctor removes a piece of the bone and bone marrow. After either test, a pathologist examines the sample to determine whether cancer is present and, if so, the nature and extent of the metastasis.

According to the American Cancer Society (2010), while bone mets are not usually curable, they can often be treated and managed. So, if you have cancer and notice any bone metastasis symptoms, see your healthcare provider right away.


American Academy of Orthopaedic Surgeons. (2007). Metastatic bone disease. Retrieved October 7, 2010, from

American Cancer Society. (2010). Bone metastasis. Retrieved October 4, 2010, from

University of Michigan Comprehensive Cancer Center. (2010). Bone metastasis. Retrieved October 4, 2010, from