How is secondary bone cancer diagnosed?

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.

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.