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Olivia Newton-John revealed on Tuesday afternoon that her breast cancer has returned and spread to her lower spine.
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 has revealed her breast cancer spread to her sacrum. Spinal metastases occur in up to 10 percent of cancer patients.
It can cause extreme back pain, bowel issues and urinary incontinence.
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.