Finding a new lump on your body can be scary. One of the first questions that may come to mind is “could this lump be cancer?” The answer is not straightforward. While some lumps that hurt are benign (non-cancerous), others may indicate cancer. There are some general factors to consider when evaluating a painful lump for cancer risk.
What Causes Lumps That Hurt?
There are many potential causes of painful lumps, both cancerous and non-cancerous. Here are some of the most common:
Non-Cancerous Causes
- Cysts – fluid filled sacs that can form in areas like the breast, ovaries, and skin.
- Abscess – a collection of pus that forms a swollen area.
- Hematoma – a collection of blood outside of a blood vessel, usually due to trauma/injury.
- Lipoma – a benign fatty tumor that develops underneath the skin.
- Sebaceous cyst – a swollen bump below the skin containing fatty material and skin cells.
- Infected hair follicle (folliculitis) – infection of a hair follicle.
Potentially Cancerous Causes
- Cancerous tumor – Uncontrolled growth of abnormal cells forming a lump.
- Lymphoma – Cancer involving the lymphatic system.
- Leukemia – Cancer involving blood-forming tissues like bone marrow.
- Metastatic cancer – Cancer that has spread from the primary site to lymph nodes or other areas of the body.
- Sarcoma – Cancerous tumor arising from connective tissues like fat, muscle, bones, and cartilage.
Pain is more often associated with non-cancerous lumps. However, sometimes cancerous lumps can be painful if they put pressure on nerves, collide with tissues and bones, or if the cancer invades nerves.
Characteristics of Lumps that May Indicate Cancer
While not definitive, certain signs raise the level of concern that a painful lump may be cancerous:
- The lump is rapidly growing in size.
- It is hard, firm, or immobile when touched.
- The borders feel irregular or poorly defined.
- It remains unchanged for more than a month.
- The lump is larger than 2 centimeters (cm) across.
- It is located just under the skin without an obvious cause like trauma.
- There are other worrisome symptoms like unexplained weight loss.
Location Matters
The location of a lump also provides important clues about whether it could be cancerous. Lumps in fatty tissue and lymph nodes have a higher cancer risk. Areas of particular concern include:
- Breast
- Testicle
- Groin
- Neck (under chin and along sides)
- Armpit
- Abdomen
When to See a Doctor
It’s always a good idea to have a new lump evaluated, especially if it hurts or has any suspicious features. Early diagnosis and treatment provides the best outcomes for cancer.
See a doctor promptly if you notice any of the following:
- A new lump anywhere on your body.
- An existing lump that has grown or changed.
- Ongoing pain in the area of the lump.
- A lump that does not go away within a month.
- An unexplained lump in lymph nodes or fatty tissue.
- Any lump in breast, testicles, or groin.
- A lump along with unintentional weight loss and/or loss of appetite.
- A lump along with fatigue, fever, or night sweats.
Diagnosing a Painful Lump
If you find a new lump that hurts, your doctor will gather information about your symptoms and perform an exam. They may ask questions like:
- When did you first notice the lump?
- Has it changed in size?
- Is it painful or tender?
- Have you had an injury in the area?
- Do you have any other accompanied symptoms?
During the physical exam, your doctor will look at the location, texture, size, and mobility of the lump. For lumps near the surface of the skin, your doctor may be able to identify the cause on exam alone. For deeper lumps, imaging tests may be recommended. Tests can include:
- Ultrasound – Uses sound waves to create images of structures beneath the skin. Helps distinguish between fluid-filled cysts and solid masses.
- Mammogram – An x-ray of the breast used to detect tumors.
- MRI – Uses magnetic fields to generate highly detailed images of structures inside the body.
- CT Scan – Combines x-rays taken from different angles to create cross-sectional images.
- PET Scan – Involves injecting a radioactive tracer into the bloodstream to detect areas of abnormal metabolic activity indicative of cancer.
For definitive diagnosis, your doctor may recommend a biopsy. This involves removing a sample of cells from the lump for examination under a microscope. A pathologist can then determine if cancer is present.
Treatment for Painful Lumps
The appropriate treatment depends on the underlying cause of the lump.
Non-Cancerous Lumps
Many non-cancerous lumps can be left alone if they are not bothering you. Warm compresses and over-the-counter pain medications can help relieve discomfort. Other options for symptom relief include:
- Aspiration – Using a needle to drain fluid from cysts to reduce size and pressure.
- Steroid injection – Injecting anti-inflammatory corticosteroids into cysts or hematomas to decrease inflammation and pain.
- Antibiotics – If infection is the cause, antibiotics can clear the infection and reduce the lump.
- Surgery – Removal may be considered for recurrent or uncomfortable lumps like sebaceous cysts.
Cancerous Lumps
Treatment focuses on destroying or removing cancerous cells. Common options include:
- Surgery – Removal of the tumor and surrounding tissue margins.
- Radiation – High energy x-rays targeted at cancer cells to damage their DNA and stop growth.
- Chemotherapy – Cancer-killing medication delivered intravenously or orally.
- Immunotherapy – Drugs that help boost the immune system to better target cancer cells.
- Hormone therapy – Used in cancers responsive to hormones like breast and prostate cancer.
Multiple treatment modalities may be combined depending on the type and stage of cancer.
Painful Lump FAQs
Here are answers to some frequently asked questions about painful lumps:
Are painful lumps always cancer?
No, the majority of painful lumps are benign. Abscesses, hematomas, and cysts often hurt due to inflammation and pressure on nearby nerves. Cancerous lumps can be painful but are usually not tender until later stages.
How can you tell the difference between a cyst and a tumor?
Cysts tend to be smooth, rounded, and compressible with well-defined edges. Tumors are generally firmer, less mobile, and have irregular borders. Imaging tests like ultrasound can help distinguish fluid-filled cysts from solid masses.
What does a cancerous lump feel like to touch?
Cancerous lumps often feel round, hard, and immobile, like a rock fixed within soft tissue. They may have uneven shapes with poorly defined edges. Poking the lump usually does not change its shape.
Can a sebaceous cyst turn into cancer?
Sebaceous cysts themselves do not become cancerous. However, a lump initially thought to be a cyst could potentially turn out to be a malignant growth. Any lump that is unsuitable for straightforward drainage should be evaluated for cancer risk.
How long is too long to have a lump before seeing a doctor?
It’s best to have any new lump evaluated right away while cancer is still in early stages and very treatable. Even lumps assumed to be benign should not be left for more than 1 month without a doctor’s assessment. Any suspicious lumps should be evaluated immediately.
The Bottom Line
While finding a new lump can be alarming, most are non-cancerous. However, any painful or persistent lump warrants medical evaluation. Early diagnosis of cancer when the lump is still small leads to the best outcomes. See a doctor for appropriate diagnostic tests and timely, effective treatment tailored to the specific cause of your lump. Catching concerns early on can mean more options and improved prognosis if cancer does happen to be found.