A diagnosis of secondary breast cancer often comes after severe chronic pain in the back or joints which is caused when the cancer has metastasised to other parts of the body and in particular to the bones.
Your Oncologist is the person who would refer you for a bone scan. When you get your appointment letter you may see it called by one of it’s more proper scientific names:
They show all changes and abnormalities to the bones. They can be used just to look at certain bones in the body or for the whole body when there’s metastatic bone cancer. They’re effective for such as long bones (arms and legs) which the CT Scan is not so useful for. In addition they show bone quality. If you’re on treatment the scan can see where the bone is showing signs of improvement or if cancer cells are stable.
You’ll be asked to attend the Nuclear Medicine or Medical Physics department. When you go for the appointment there’s no particular preparation so you can eat and drink as normal. If you wear clothes with no metal on then you won’t have to take anything off at all. So pull on trousers or skirt and a tea shirt are ideal. You won’t need to take off jewellery nor even an underwired bra. (If you’re pregnant or breast feeding make sure they know and you’ll be advised what to do).
You’ll be asked to attend 3 hours or so before the time of the actual scan. So read your appointment letter carefully. That’s because when you first arrive you’ll see a nurse in the department who will go through the procedure and make sure you understand and you can also ask questions. Then you’ll have a small canular in a vein usually in your arm through which there’ll be an injection of a radioactive liquid or radioactive tracer. It’s a small amount of radiation and causes no feelings of side effects. The tracer collects more in areas where the bone is breaking down and repairing itself. These areas of activity or hot spots show on the scan and are darker than other areas of bone.
You will then need to wait 2 to 3 hours while the radioactive tracer travels through the blood and collects in your bones. During this period you can normally go off and do something else and it’s important to drink lots of liquid to help flush the radioactive tracer round the body. When you return to the department for the actual scan you may be asked to drink a cup of water and to go to pass urine if you’ve not just done so.
The scan takes between 30 to 60 minutes and the technician stays in the room with you. You’re ordinarily asked to lie down on your back and keep still while the scanner takes numerous pictures of your body. With metastatic cancer it’s sometimes in the spine and so your back may be very painful and even impossible to lie on. Make sure you tell the nurse that you first see or the technician because they can get you extra cushioning and pillows to help make your more comfortable and if it really is impossible to lie on your back then they can totally adjust the machine so it can be done standing if you are able to do that.
You are normally free to go home straight after the scan and you’ll be asked to drink plenty of water to flush the tracer out of your system within 24 hours.
The scan is looked at by a specialist doctor and the results then ordinarily passed over to your consultant Oncologist who will let you know what is discovered. Results normally take between 1 or 2 weeks.
If your cancer is relative stable then the bone scan is usually annual If you’ve extensive metastatic cancer in your bones or it’s accompanied by osteoporosis then you may have it more regularly (6 monthly) to keep a good check on things. If you develop new symptoms your Oncologist may refer you for a bone scan more frequently.
Written by Susan Beevers, Make 2nds Count Community Member