Bone cancer can cause severe pain. The pain levels vary depending on the type of bone cancer, its stage, location, and other factors. While some bone cancers may not be very painful in the beginning, most types tend to become increasingly painful as the disease progresses if left untreated.
What is bone cancer?
Bone cancer is an abnormal growth of cells within the bones that multiplies uncontrollably and forms a mass of cells called a tumor. This tumor can destroy healthy bone tissue and compromise the structural integrity of the bone.
There are several different types of bone cancers, including:
– Osteosarcoma – The most common type of bone cancer that typically starts in the bones that make up the arms, legs or pelvis. It occurs most frequently in children and young adults.
– Ewing’s sarcoma – The second most common type of bone cancer in children and teens. It often starts in the bones of the leg, pelvis, chest, arms or spine.
– Chondrosarcoma – Starts in cartilage cells and most often occurs in adults.
– Multiple myeloma – Starts in the plasma cells of bone marrow and most often affects adults.
– Chordoma – A rare cancer that develops more commonly in adults along the spine.
– Rare bone cancers – Other less common bone cancers include fibrosarcoma, malignant fibrous histiocytoma, and telangiectatic osteosarcoma.
What causes bone cancer pain?
The cancerous tumor grows and presses on the healthy bone tissue, causing damage and pain. Other causes of bone cancer pain include:
– The tumor eats away areas of healthy bone – This can lead to fractures and collapsed bones that are very painful.
– Cancer spreads to other bones – Metastasis to multiple sites increases pain.
– The tumor presses on nerves – Pressure on nerves near the tumor can cause severe nerve pain.
– Cancer treatment – Chemotherapy, radiation, or surgery can also contribute to pain.
What does bone cancer pain feel like?
The symptoms of bone cancer depend on the location and can include:
– Aches, pains or swelling around the affected bone
– Limb pain that worsens over time, especially at night
– Difficulty using the limb due to pain
– Fractures with minimal trauma due to tumor weakening the bone
– Compression of nerves causing shooting, stabbing or burning pain
The pain often increases with movement and activity and lessens with rest. Lying down flat typically reduces the pain. As the tumor grows, pain can become constant and severe enough to require strong prescription painkillers.
Does the pain get worse?
In most cases, the pain caused by bone cancer tends to worsen over time as the tumor grows and spreads.
– In early stages, pain may only occur at night or with activity.
– As the cancer advances, the pain intensifies and becomes more constant and severe.
– Metastasis to other bones causes pain in multiple sites.
– Chemotherapy and radiation can cause pain flare ups.
– Pathological fractures worsen pain.
So while bone cancer may not be very painful at first, it typically becomes progressively more painful if not treated. Seeking prompt treatment is important for controlling cancer growth and associated pain.
Does the pain depend on the location?
Yes, the location of the primary bone tumor affects the type and severity of pain experienced:
| Tumor Location | Type of Pain |
|---|---|
| Leg or arm bones | Deep, dull ache that worsens with use; limb swelling |
| Pelvis | Deep ache in hip/groin; difficulty walking |
| Spine | Severe back pain that worsens with movement; numbness |
| Rib cage | Pain with breathing; tender ribs |
| Skull | Headache; facial pain |
| Upper arm/thigh | Joint and limb pain; fractures |
Tumors near joints, arms or legs often cause the most functional disability and pain. Spinal tumors can compress nerves causing shooting limb pains. Ribs or skull tumors also produce significant pain.
Why does location matter?
Certain bones are more vulnerable to fractures and nerve compression:
– Tumors in leg and arm bones weaken the structural integrity – This increases fracture risk and pain with use.
– The spine has many nerves – Spinal tumors can press on spinal nerves causing radiating pain.
– Pelvis and hip tumors – Make walking very difficult and painful.
– Tumors near joints – Can limit mobility and cause severe joint pains.
– Rib tumors – Impair breathing and cause pain with each breath.
So skull, spine, arm and leg tumors often cause the most severe nerve and mechanical bone pain due to nerve impingement and fractures. Pelvic and rib tumors also produce significant pain.
Does bone cancer pain differ by type?
Yes, certain types of bone cancers tend to cause worse pain:
| Bone Cancer Type | Pain Severity |
|---|---|
| Osteosarcoma | Very painful due to bone destruction |
| Ewing’s sarcoma | Very painful, often metastatic |
| Chondrosarcoma | Milder pain unless pelvic tumor |
| Chordoma | Severe pain if spine involved |
| Multiple myeloma | Widespread bone pain likely |
Osteosarcoma and Ewing sarcoma most aggressively invade and destroy bone tissue, leading to intense pain. Multiple myeloma commonly spreads to multiple bones causing widespread pain. Chondrosarcomas and chordomas vary in pain severity by location.
Why do some bone cancer types hurt more?
Some key differences that contribute to pain levels:
– Osteosarcoma forms immature bone – This bone is weaker and more prone to fracture and pain.
– Ewing sarcoma spreads earlier – Metastasis to multiple bones makes pain more widespread.
– Chondrosarcomas spare the bone – By growing in cartilage, bone destruction is limited.
– Multiple myeloma spreads quickly – Multiple areas of bone loss ratchets up pain.
– Chordomas compress nerves – Spinal chordomas severely impair nerve function.
So the bone cancer types that aggressively destroy skeletal structure and compress nerves (like osteosarcoma, Ewing sarcoma, and myeloma) generally produce the most intense bone pain.
Does pain increase with bone cancer progression?
Yes, bone cancer pain typically worsens as the disease progresses when left untreated:
| Stage | Pain Severity |
|---|---|
| Stage 1 | Mild pain with activity; minor bone damage |
| Stage 2 | Worsening pain; more bone destruction |
| Stage 3 | Severe constant pain; nerve compression |
| Stage 4 | Very severe pain; metastasis; fractures |
In stage 1, pain may only occur with use of the limb. As bone damage worsens in later stages, the pain becomes constant and more intense. Stage 4 metastatic disease causes severe pain in multiple sites.
Why does the pain get worse with progression?
As the cancer advances, several factors drive up pain:
– Larger tumor destroys more bone – This weakens the bone and increases fracture risk.
– Metastasis to other bones – Having tumors in multiple bones makes pain more widespread.
– Tumor presses on nerves – Nerve compression causes burning, shooting pains.
– Cancer treatment side effects – Chemotherapy and radiation can both increase pain.
– Risk of pathological fracture – Weakened bone is vulnerable to fracture with minimal force.
So both increased destruction locally and spread to other sites via metastasis increases cancer-related bone pain as the disease progresses.
Conclusion
Bone cancer often causes severe, progressively worsening pain, especially with types like osteosarcoma and Ewing sarcoma that aggressively destroy bone. Pain levels depend on location, with tumors near joints, limbs, spine and ribs being most painful due to fracture and nerve compression risk. Pain typically intensifies as the cancer grows locally and spreads to new sites. Seeking prompt treatment is key to stabilizing bone damage and pain levels. Analgesics, chemotherapy, radiation, or surgery may be required for pain management.