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If you have cancer that has spread to the bone, you probably have pain. It may be right at the place where the cancer has metastasized or in areas surrounding it. It may be worse at night and when you rest, or it may be better when you rest and worse with movement.

No matter how pain behaves, it is the most common complaint of people with bone metastasis, says Julie Fasano, MD, medical oncologist with Memorial Sloan-Kettering Cancer Center's Commack Facility in Long Island, N.Y. In fact, 70% of people with bone metastases, or "mets," have bone pain.

Pain can be scary, especially if you think you can't do anything about it. But you can do something about pain caused by bone metastasis. "There's a lot we can do to reduce the pain," Fasano says. "There's no reason why any cancer patient has to live with pain." This guide can help you get started.

Understanding and Tracking Bone Metastasis Pain

Metastatic cancer cells damage bones and cause pain several ways:

  • They produce substances that can dissolve and weaken bones. This may cause a bone to break, which is painful.
  • As the tumor grows in the bone, nerve endings in and around the bone also send pain signals to the brain.
  • They may make bones harden. This is called sclerosis.

It's important to remember that not all of your pain may be caused by metastasis. Of course, it's natural to think that may be the cause, Fasano says. But there are other causes of severe pain. For example, severe shoulder pain could be from a frozen shoulder or tendonitis, she says.

So how do you know if it's cancer pain? One difference is that cancer pain persists while other types of pain are more likely to come and go. Still, it's important to get any new or changing pain checked out.

"If you have persistent bony pain, bring it to the attention of your oncologist," Fasano says. "I always encourage my patients to call with any questions." Otherwise, she adds, the anxiety from not knowing can be very stressful.

For the Best Pain Relief, Keep a Diary

If you have bone metastasis, you can help manage the pain by keeping track of it. "A really clear understanding of the pain is going to help the most," says Julie R. Gralow, MD, professor of medical oncology at the University of Washington School of Medicine and director of breast medical oncology at the Seattle Cancer Care Alliance.

She advises keeping a pain diary so that you can answer questions your oncologist may ask, like:

  • When is your pain the best and worst -- for example, with movement or when lying down?
  • How severe is the pain on a scale of 1 to 10?
  • What is the pain like? Is it burning? Sharp? Dull?
  • Where is the pain located? In one place? In several places?

Providing this kind of information to your doctor can help ensure effective treatment, says Gralow. "Very good communication is going to get you the best pain relief."

How Cancer Spreads to Bones

See what bone metastasis does to your bones, and how to fight back.
View slideshow