Signs and Symptoms

of Bone Cancer

The first symptom of bone cancer is usually pain or tenderness near the cancer. Bone pain is caused by stretching of the periosteum (thick membrane that covers bone) by the cancer, or by stimulation of nerves within the bone. Bone pain may be hard to differentiate from ordinary low back pain or arthritis. Usually the pain due to bone metastasis is fairly constant, even at night. It can be worse in different positions, such as standing up, which may compress the cancer in a weight bearing bone. If pain lasts for more than a week or two, doesn’t seem to be going away, and is unlike other pain that may have been experienced, it should be evaluated by a physician.1,2

A patient may also experience a pathological fracture as the first sign of bone cancer. A pathological fracture is a break in a bone due to problems within the bone itself rather than by external factors, such as force. Pathological fractures are caused when the cancer destroys enough bone that the skeleton can no longer support normal body functions adequately.

  • Pain. The earliest symptoms of bone cancer are pain and swelling where the cancer is located. The pain is tends to come and go at first, but ultimately becomes constant.
  • Joint swelling and stiffness. When a bone cancer occurs near or in a joint it may cause the joint to swell and become tender or stiff.

Cause

Bone cancer begins when healthy cells acquire a genetic change (mutation) that causes them to turn into abnormal cells.

Risk factors

  • A risk factor is anything that increases a person’s chance of developing cancer. Risk factors can influence the development of cancer but most do not directly cause cancer. Many individuals with risk factors will never develop cancer and others with no known risk factors will.
  • Some bone cancers develop sporadically, which means for no known reason some result from other primary cancers that have spread to the bone, and some begin in the bone. Each of the following factors may raise a person’s risk for developing bone cancer:1,2
  • Risk factors for bone cancer include:
  • Known primary cancer. Cancers that begin in the lungs, breast, colon, prostate and other locations may all spread to the bone.
  • Previous radiation therapy. People who have had radiation treatment for other conditions have a higher risk of developing bone cancer at the site of the radiation therapy. The majority are sarcomas but other types of cancer may occur.
  • Chemotherapy for another cancer. Some drugs, including alkylating agents and anthracyclines, used to treat cancer may increase the risk of developing a secondary cancer, usually osteosarcoma.
  • Benign tumors or other bone conditions. Paget’s disease of the bone may lead to osteosarcoma. Other noncancerous bone diseases, such as fibrous dysplasia, may increase the risk of osteosarcoma.
  • Genetic Syndromes
    • Familial retinoblastoma which is a type of eye cancer have an increased risk of developing osteosarcoma.
    • Li-Fraumeni syndrome is also at high risk for sarcoma and osteosarcoma bone cancers.

Next: Diagnosis & Tests for Bone Cancer

References


1 American Cancer Society. Cancer Facts & Figures 2016.

2 National Cancer Institute Fact Sheet. Human Papillomaviruses and Cancer: Questions and Answers.