Bone pain and weakened bones

How can cancer and cancer treatment affect the bones?

Bone or joint pain 

If your cancer is affecting your bones it can cause pain. For example a nagging ache in your bone. Cancers such as multiple myeloma and osteosarcoma start in the bones. This can damage the bone and cause pain. Or sometimes cancer spreads to the bones. 

Some drug treatments, such as hormone therapy, some targeted therapies and immunotherapies can also cause pains in your joints or bones. This often settles down after a few weeks.

Remember pain in your bones can be caused by other things such as arthritis, simple sprains and everyday aches and pains as you get older. If you have a new ache that lasts more than a few weeks, talk to your doctor. They can organise tests to find the cause of the pain.

How is bone pain treated?

The best treatment for your bone pain will depend on how bad the pain is and what’s causing it. 

Painkillers

Mild pain is often helped with drugs such as paracetamol or anti-inflammatory drugs like ibuprofen. Moderate and severe pain needs stronger painkillers such as codeine or morphine. If your medication does not kill the pain, tell your doctor or nurse.

Or you might see a specialist who manages pain and other symptoms. They can arrange for you to try out different drugs and types of painkillers to see which one suits you best. Read more about controlling pain.

Bone-strengthening drugs

Medications known as bisphosphonates and monoclonal antibodies can help to relieve bone pain. They can also strengthen your bones and reduce the risk of fractures. 

Radiotherapy

Radiotherapy is very good for treating bone pain caused by metastatic cancer. The treatment kills off the cancer cells and can be given as a single dose or divided over a few days. It can take 2‒3 weeks to work. Sometimes it can cause a flare-up of pain for a few days after treatment. 

Weakened bones

Metastatic cancer in the bones or cancer that affects your bones, such as multiple myeloma, can make your bones weaker and more likely to break (fracture). 

Some treatments can also lead to bone loss conditions osteopenia or osteoporosis. These include:

• Hormone therapies
• Chemotherapy drugs that reduce the production of hormones in the body
• Radiotherapy that affects a woman’s ovaries
• Surgery to remove a woman’s ovaries or a man’s testes
• Steroids

You may have a special scan called a DEXA scan before, during or after your treatment to check for signs of osteopenia and osteoporosis, to see if you’re at risk of breaking a bone. Read more about DEXA scans.

How are weakened bones treated?

Bone-strengthening drugs

Medications known as bisphosphonates and monoclonal antibodies can also strengthen your bones and reduce the risk of fractures. We have more information on bone-strengthening drugs.

Surgery

If a bone is very weak, you may need surgery to strength it. This is done in hospital under a general anaesthetic.

Your surgeon will put a pin into the centre of the weakened bone and might fix a metal plate to hold the bone firm as well. You will need to stay in hospital for a week or so to recover after this surgery.

Spinal cord compression

If cancer has spread to the bones of the spine (vertebrae), it can cause pressure on the spinal cord. This is called spinal cord compression. It’s important to get treatment straight away if you have cancer and you notice numbness and loss of power in your legs. Read more about spinal cord compression. 

Too much calcium in the blood (hypercalcaemia)

Breakdown of bone cells can release extra calcium into your blood. A high calcium level in your blood is called hypercalcaemia. This can make you feel thirsty, sick, constipated or drowsy. It is very important to tell your doctor immediately if you have any of these symptoms. Read more about hypercalcaemia