Olivia Newton-John revealed on Tuesday afternoon that her breast cancer has returned and spread to her lower spine.
The 68-year-old shared the news with fans while announcing she had 'reluctantly' postponed her U.S. and Canadian concert tour dates, which were set for June.
She was first treated for breast cancer in 1992, at the age of 43. She underwent a partial mastectomy, chemotherapy and breast reconstruction.
When breast cancer spreads beyond the breast tissue it is known as 'metastatic breast cancer'. That means it has metastasized (spread) to other parts of the body such as the bones, lungs, liver or brain.
Metastatic breast cancer is also known as stage 4, the most advanced stage - there is no stage 5 - with a 22 percent chance of surviving five years.
There is no cure, but it can be treated, and in many cases successfully.
Olivia Newton-John's breast cancer has returned and spread to her lower spine, meaning she will need radiotherapy to target the delicate area. Pictured: singing in Atlanta in April this year
There are many ways breast cancer can spread without being detected.
Cancer cells can invade nearby healthy cells, before replicating and spreading.
They can also break through the walls of nearby lymph vessels under the armpits.
Once in the lymph system, cancer cells can travel in the bloodstream to other parts of the body.
Or they can get inside capillaries before dividing and migrating into the surrounding tissue.
While it is not uncommon for cancer to spread, just 10 percent of patients experience secondary cancer in their sacrum, the base of the spine.
It can cause extreme back pain, bowel issues and urinary incontinence.
Since the sacrum is located very close to neural and vascular structures, surgery can be complicated.
As a result, most patients are treated with radiotherapy - which is what Olivia plans to do.
A statement on her social media on Tuesday read: '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 addition to natural wellness therapies, Olivia will complete a short course of photon radiation therapy and is confident she will be back later in the year, better than ever, to celebrate her shows.'
She added: 'I decided on my direction of therapies after consultation with my doctors and natural therapists and the medical team at my Olivia Newton-John Cancer Wellness and Research Centre in Melbourne, Australia.'
The message concluded with a statement that the actress will not be accepting requests for interview and that fans can request refunds for the June concert dates directly from the venues.
Olivia initially postponed the first half of her tour earlier this month as she was suffering with back pain which she thought was sciatica.
A Facebook post read: 'We are so sorry to announce that the Olivia concerts scheduled for May will be postponed due to a bad issue with Olivia's sciatica.'
Following the first announcement on May 9 the star's daughter Chloe Lattanzi asked fans for 'healing prayers'.
Earlier in May, Olivia told fans she had to postpone her tour due to sciatica, a back condition. But days later her daughter Chloe (together, left) asked fans for 'healing prayers'. The family has now revealed Olivia (pictured, right, in the hit movie Grease) is battling cancer again
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