Olivia Newton-John's Back Pain Was a Sign Her Breast Cancer Returned

The singer's breast cancer has metastasized.
Olivia NewtonJohn performing
Ross Gilmore / Getty Images

Olivia Newton-John of Grease fame will sadly be putting her tour on hold while she gets treatment for breast cancer. The singer, 68, made the announcement via a press release on her Facebook page. “Olivia Newton-John is reluctantly postponing her June U.S. and Canadian concert tour dates,” the announcement said. “The back pain that initially caused her to postpone the first half of her concert tour has turned out to be breast cancer that has metastasized to the sacrum.”

In early May, Newton-John announced on Facebook that she had to postpone a few shows due to a “long-running issue with sciatica,” a condition that causes pain to radiate along the sciatic nerve, which can be felt in the lower back and along a person’s legs. Her management also referenced her back pain in a May 24 Facebook post while announcing that she would limit her appearances in June.

“As most of you know, Olivia has been suffering from severe back pain, so her focus for the upcoming shows is to put on the best, most uplifting performance for everyone,” the post read. “In order to ensure this, Olivia will not be doing any meet and greets for the concerts in June.”

In her latest announcement, Newton-John’s team said the singer would undergo treatment like a “short course” of photon radiation therapy, a form of radiation that uses X-rays to target tumors in a patient’s body. A source close to the singer tells People that Newton-John, who also dealt with breast cancer in 1992, plans to start touring again in August.

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Although this news is scary, it's important to know that back pain isn't a common symptom of most breast cancer cases.

Back pain is an incredibly common issue, so it makes sense that someone wouldn't assume it's a sign of a serious illness. That's a good way to think about it, because in most cases, back pain has nothing to do with breast cancer.

But unfortunately, it's not unusual for someone with a history of breast cancer, like Newton-John, to experience back pain as a symptom when their cancer returns. "For most individuals with breast cancer that has metastasized to bone or to other organs, there is a prior history of early stage breast cancer," Halle Moore, M.D., a hematologist and oncologist at the Cleveland Clinic Taussig Cancer Institute, tells SELF. She adds that less than 5 percent of breast cancers have already spread when a person is first diagnosed with the disease, so back pain is not a common symptom if a person has never been diagnosed before.

Back pain can be a symptom of metastatic breast cancer because when this disease spreads, it often goes to bone, Benjamin Smith, M.D., an associate professor of radiation oncology at MD Anderson Cancer Center, tells SELF. (Two other common locations are the liver and the lungs.) Cancer's growth can disrupt the sensitive outer shell of the bone, Dr. Smith says. The cancer can also weaken the bone, causing a partial or complete fracture, or directly impact a nerve exiting the spinal cord, which can also cause pain, he says.

Breast cancer can “go to any bone,” Steven J. Isakoff, M.D., Ph.D., a breast medical oncologist at Massachusetts General Hospital Cancer Center who researches new treatments for metastatic breast cancer, tells SELF. However, there are a few locations that are most likely.

“For reasons we do not fully understand, the most common bones [affected by breast cancer metastasis] are those in the central skeleton such as the spine, hip/pelvic bones, and ribs,” Dr. Smith says. Newton-John's Facebook post mentions her sacrum, which is a bone in the lower back at the bottom of the spine. It’s not rare that someone would confuse metastatic breast cancer in their spine with sciatica or other benign back conditions, Dr. Smith says.

Breast cancer can live in a person’s bone marrow for years before growing and causing destruction to the rest of the bone, Brian Czerniecki, M.D., Ph.D., chairman of the Breast Cancer Oncology Department at Moffitt Cancer Center, tells SELF. As the bone tries to heal itself, the destruction left by the cancer can be picked up on a CT scan or MRI. This also reinforces how uncommon back pain is as a symptom of breast cancer—Dr. Smith points out that most breast cancers are spotted with an abnormal mammogram or a mass in a patient’s breast, not via CT scan or MRI due to back pain.

There are often major differences between normal back pain and the kind that could be a sign of breast cancer.

Back pain related to breast cancer isn't the same as the kind from, say, pulling a muscle. Normal back pain may be associated with a specific injury and improve over time, or it can feel worse or better when you make certain movements, Dr. Isakoff says.

However, back pain from breast cancer may be more constant, not necessarily linked with movement, and not associated with any type of injury. “It also tends to get worse over time, sometimes over weeks or months rather than getting better,” he says.

If you experience back pain, it’s much, much more likely that it’s just back pain rather than a sign of something worse. But, if you have a history of breast cancer and have back pain that doesn’t improve with treatment, Dr. Isakoff says it’s worth flagging for your doctor. “However, even in a patient with a history of breast cancer, most new onset back pain will be unrelated,” he says.

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