Signs and Symptoms of Bone Cancer

Bone cancer is a rare type of cancer that begins in the bone cells. The bones are made up of a hard, outer layer called the compact or cortical bone and a spongy inner layer called the trabecular bone. New bone cells are always forming to keep your bones strong. However, when cancer cells start to form in bone cells and create a tumor, symptoms like pain, swelling, and fractures can occur.

Primary bone cancer (cancer that starts in the bone) is rare. It's more common to experience metastatic cancer in the bones. This occurs when cancer starts in one area of the body, such as the lungs, breast, or prostate, and then spreads to the bones.

Knowing the signs of bone cancer is essential because it can help you receive an early diagnosis and get you started on treatment sooner.

Pain 

Pain is the most common symptom of bone cancer. The level of pain depends on several factors including the type of bone cancer you have, its location, and how far the cancer has spread. 

Bone cancer pain first occurs in the location of the tumor. At first, the pain may come and go. It often feels worse at night or when the bone is being used. For example, walking will make bone cancer in the leg feel worse. As bone cancer grows and spreads, the pain usually increases and becomes constant.

Where you experience pain will often vary by the type of cancer you have:

• Osteosarcoma: Develops in the bones in the arms, legs, and pelvis 
• Ewing sarcoma: Affects the pelvis, ribs, shoulder blades, spine, and legs
• Chondrosarcoma: Forms in the pelvis, legs, arms, ribs, shoulder blades, and skull

A 2018 study found that 21-37% of people with osteosarcoma and 19% of those with Ewing sarcoma experience more severe nighttime pain. 

Swelling or Lumps

Some people with bone cancer experience swelling or develop a lump at the site of the tumor. Most people with bone cancer experience pain first. As the tumor grows, it may lead to swelling in the area. The location of the tumor can also feel warm to the touch and appear red in color.

A lump or swelling can also cause additional symptoms. For example, bone cancer in the neck may cause difficulty swallowing or trouble breathing due to the tumor. If your bone cancer is affecting your arm, swelling may cause more pain and decreased range of motion.

Fever

Bone cancer may cause you to experience frequent fevers. You may develop an unexplained fever that comes and goes for weeks or months. It's important to see your healthcare provider if you experience a fever with no other symptoms, as this may be an underlying sign of a variety of conditions. 

Fractures

A tumor weakens bones over time and raises the risk of a fracture. Up to 8% of people with osteosarcoma may experience a fracture at some point. A fracture from bone cancer may feel like a sudden onset of intense pain and cause symptoms like weakness and stiffness in the location of the tumor.

Neurological Symptoms

When bone cancer develops in the bones in your spine, it can lead to neurological (brain or spinal cord-related) symptoms. This often occurs when the tumor presses on nerves in the spinal cord. Possible symptoms include:

• Numbness in the arms and legs
• Weakness
• Tingling sensations throughout your body. 

These symptoms can either be constant or come and go.

Advanced Symptoms 

As bone cancer grows and spreads, it's possible to develop more severe symptoms over time. Advanced bone cancer may cause symptoms like:

• Unintentional weight loss
• Difficulty breathing (especially, if your cancer spreads to the lungs)
  
• Fatigue

Symptoms in Children

Bone cancer can develop in both adults and children. Generally, symptoms of bone cancer are the same regardless of age. In both children and adults, pain is the most common symptom of bone cancer. 

Osteosarcoma is the most common type of bone cancer and may occur in children aged 10-19. Ewing sarcoma is the second most common type of bone cancer in children and adolescents. Other possible symptoms in children include swelling, a lump, and fevers.

When to Contact a Healthcare Provider 

Experiencing signs of cancer can be very worrisome. If you have symptoms, it's important to contact your healthcare provider as soon as possible for proper testing and diagnosis. It may help to remember that primary bone cancer is rare and makes up less than 1% of all cancers. In most cases, the symptoms of bone cancer are caused by less serious factors such as an injury or infection. 

It is also possible to experience a benign bone tumor that has the same symptoms as bone cancer. Non-cancerous bone tumors include:

• Osteoid sarcoma
• Osteoblastoma
• Osteochondroma 
• Enchondroma 
• Chondromyxoid fibroma 

If you have symptoms, don't wait. Getting an early diagnosis can improve the outlook of your condition greatly.

A Quick Review 

Bone cancer is an uncommon type of cancer that makes up less than 1% of all cancer cases in the United States. The earliest and most common symptom of bone cancer is pain at the location of the tumor. At first, the pain may come and go. As the cancer spreads, the pain will likely be present all of the time. Other possible symptoms include swelling, fractures, and fever.

If you have symptoms, see your healthcare provider soon for a timely diagnosis.