Signs and Symptoms of Bone Metastasis
Many of the symptoms listed here can also be caused by something other than the spread of cancer to the bones. Still, it’s very important for you to tell your cancer care team about any new symptoms you have. Finding and treating bone metastasis early can help prevent problems later on.
Bone pain is often the first symptom of cancer that has spread to the bone. The pain may come and go at first. It tends to be worse at night and may get better with movement. Later on, it can become constant and may be worse during activity.
It’s important to tell your doctor right away about any new pain that might be coming from a bone. The bone might be so weakened that it will break. This can often be prevented if the bone metastasis is found early. Keep in mind that other diseases, such as bone infections, arthritis, or just being very active can also make bones hurt.
Bones weakened from metastatic cancer may break or fracture. The fracture can happen with a fall or injury, but a weak bone can also break during everyday activities. These fractures often cause sudden, severe pain. The pain may keep you from moving.
The most common fractures are in the long bones of the arms and legs and the bones of the spine. Sudden pain in the middle of the back, for example, is a common symptom of a bone in the spine breaking and collapsing from cancer.
Spinal cord compression
Cancer growth in the bones of the spine can press on the spinal cord. This is called spinal cord compression and is very serious. The spinal cord has nerves that allow you to move and feel what happens to your body. Some of these nerves also control other functions such as bowel and bladder control.
One of the very earliest symptoms of spinal cord compression is pain in the back or neck. Pressure on the spinal cord can damage the nerves in the spinal cord, leading to symptoms like numbness and weakness in the area of the body below the tumor.
If a spinal cord compression isn’t treated right away, the person can become paralyzed. Most often this affects the legs (so that the person can’t walk) but if the tumor is pressing on the spinal cord in the neck, both the arms and the legs can be affected.
Sometimes the first symptom you may have of spinal cord pressure is trouble urinating because nerves from the spinal cord control the bladder. You may also feel more constipated (because nerves from the spine help you move your bowels).
High blood calcium levels
When cancer spreads to the bones, calcium from the bones can be released into the bloodstream. This can lead to high levels of calcium in the blood called hypercalcemia (HI-per-kal-SEE-me-uh). This can cause problems such as constipation, nausea, loss of appetite, and extreme thirst. The high calcium also causes you to make more urine, leading to dehydration. It can make you feel very tired and weak, too. You may be sleepy or even confused. If hypercalcemia is not treated, you can even go into a coma.
Chow E, Finkelstein JA, Sahgal A, Coleman RE. Metastatic cancer to the bone. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2011: 2192-2204.
Coleman RE, Holen I. Bone metastasis. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier; 2014: 739-763.
Last Medical Review: May 2, 2016 Last Revised: May 2, 2016