How Does Back Pain Caused By Cancer Differ From Non
It is often impossible to tell the difference between back pain caused by cancer and that caused by other sources because swelling from either a tumor in the vertebra or general inflammation exerts pressure on the nerves of the spine, producing the same type of pain. The difference is in the duration of the pain, the accompanying symptoms, and what types of activities trigger the pain.
When the cause is caused by cancer, the pain often:
- Doesnt seem to be related to movement
- Occurs mostly at night or early morning and gets better during the day
- Persists even after physical therapy or other treatments
- Is accompanied by fatigue, sudden weight loss, or other symptoms depending on the type of cancer.
The Lottery Of Lung Cancer
Given her new diagnosis, Samantha was transferred to MD Anderson Cancer Center, in Houston, where she underwent more tests. Initially, doctors planned to remove just her right lunguntil they discovered that the cancer had spread to her left lung. At the same time, more tests also uncovered what turned out to be hopeful news: Samantha had the EGFR mutation.
“I won the lottery of lung cancer I think, because there were drugs that were targeted for my type of mutation,” says Samantha, who had non-small cell lung cancerwith a genetic mutation of epidermal growth factor receptor . According to CancerCare, a national non-profit, that mutation means she produces too much EGFR protein, a normal substance that helps cells grow and divide, so her cells grow and divide too quickly. The lucky part? Unlike other cancers and mutations, there is a targeted and potentially effective treatment for the EGFR mutation. Drugs known as EGFR inhibitors block the EGFR receptors on the cell surface, slowing or stopping the growth of the cancer. Doctors put Samantha on one of these drugs.
“I just knew it was stage IV cancer, because it came from another organ.”
“It recognizes the mutation in my DNA, so I dont get nearly the side effects Id get on chemo,” says Samantha. “But I have to take it once a day for the rest of my life. And, eventually, it will stop working.”
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Early Warning Signs And Symptoms Of Lung Cancer
Most lung cancers don’t cause symptoms until the disease has advanced, in part because the lungs have few nerve endings. When lung cancer does cause signs in its early stages, they may vary from person to person. However, lung cancer symptoms may include:
- A new cough that is persistent or worsens, or a change in an existing chronic cough
- Cough that produces blood
Less common symptoms of lung cancer may include:
- Swelling in the face or neck
- Difficulty swallowing or pain while swallowing
- Changes in the appearance of fingers, called finger clubbing
Although most of these symptoms are more likely to be caused by something other than lung cancer, it’s important to see a doctor. Discovering lung cancer early may mean more treatment options are available.
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When Should I See A Specialist About A Pancoast Tumor
If you are concerned that the shoulder pain youre experiencing may be related to a Pancoast tumor, its a good idea to consult with an oncologist who specializes in this type of cancer. As discussed, this type of cancer is incredibly uncommon and its crucial to work with a specialist who understands and regularly treats Pancoast tumors. Thats why you should visit a high-volume cancer center, such as Moffitt Cancer Center, for advanced diagnosis and treatment of Pancoast tumors. Our experts possess a unique level of experience with uncommon lung malignancies such as these, and we have several oncologists who specialize in Pancoast tumor treatment.
Consider seeking out the Pancoast tumor specialists at Moffitt if you have been diagnosed with this type of tumor, your physician believes you might have this malignancy and has ordered additional testing or youre experiencing unusual symptoms in addition to shoulder pain that havent gone away on their own after several days.
What Does Lung Pain Feel Like
Lung pain is often characterized by patients as a sharp, dull, burning, aching, stabbing, or crushing sensation. These painful feelings can be intimidating and scary, however, there are many potential causes. Chest pain when breathing has been directly linked to conditions such as mesothelioma, lung cancer, and many others across the board.
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Where Are The Lungs Located On The Back
The lungs are located in the chest cavity between the heart and the spine.
They are a delicate yet vital organ of the respiratory system and are vulnerable to a range of illnesses.
The pair of spongy organs are lined by a thin membrane called the pleura, which helps protect and cushion the lungs.
They are housed inside the ribcage for protection, with the top of the lungs located just above the collarbones.
What Does Back Pain In Lung Cancer Feel Like
Because lung cancer tumors manifest in many different forms and locations, it is difficult to put a general description on the back pain caused by lung cancer. Some people with metastatic lung cancer have described upper or lower back pain that radiates outward, sometimes accompanied by feelings of numbness or weakness in the legs. Some people have also noted that they experience a tingling sensation racing down their legs alongside back pain, signifying nerve involvement or leptomeningeal metastasis.
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When To Talk To Your Doctor
If youre experiencing symptoms and at an increased risk of developing lung cancer, you should talk to your doctor about having a routine screening, Dr. Hales says.
Screenings for people at high risk of developing lung cancer offers hope for early detection, when surgery is a possible cure. Read more about lung cancer screening.
People considered at high risk for developing lung cancer:
- Have a history of heavy smoking
- Are current smokers or former smokers who quit within the past 15 years and
- Are between the ages of 55 and 80.
If your doctor detects anything abnormal during a lung cancer screening, diagnostic tests such as imaging scans and biopsies are the next step. Read more about how to reduce your risk of lung cancer.
Treatment For Chest And Lung Pain
Whether a patient has been diagnosed after experiencing lung cancer symptoms or remains undiagnosed, they are eligible for treatment. Improving a diagnosis and sticking to a treatment plan is a complex thing to navigate, so there are several options.
Options like medications, therapies, and other techniques all present their own set of potential risks and benefits. Additionally, lung and chest treatment can cost a significant amount so its best to select one that is the best fit for your lifestyle.
Pain Medication for Chest Pain
A common treatment for chest pain is pain medication. Pain medication is a non-intrusive way to manage pain. Medication often attacks sick cells or simply eases the pain a patient may experience. Typical drugs used to treat general chest pain include:
- Emergency dissection repair
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Expected Symptoms Of Lung Cancer
Lung cancer produces symptoms that most people would expect. These symptoms are tied to the basic functions of our lungs. These symptoms include:
- Coughing. Coughing that doesnt go away or gets worse.
- Shortness of breath. Feeling out of breath, tightness in the chest, feeling like you cant breathe, or feeling you cant get enough air.
- Coughing up blood, phlegm, or mucus. Coughing up blood-tinged or rust-colored phlegm or mucus.
- Chest pain. Pain that gets worse with laughing, coughing, or deep breathing.
- Wheezing. Wheezing is that high-pitched whistling sound that happens when exhaling.
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Causes Of Lung Cancer
Some of the following behaviors or conditions might make you consider having your back pain evaluated by a medical doctor. If you have any of these risk factors, your back pain may relate to possible lung cancer:
- Smoking cigarettes and cigars
- History of lung cancer in the family
- Asbestos or other carcinogen exposure
Certain substances such as asbestos can increase the risk of developing lung cancer or mesothelioma, a cancer of the lining surrounding the lungs and other body parts.
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What Does Lung Cancer Shoulder Pain Feel Like
Shoulder pain from lung cancer is quite similar to other forms of shoulder pain. Because of this, it might be difficult to determine the cause of your shoulder pain.
If youve recently fallen or injured your shoulder in some way, lung cancer is unlikely to be the cause of your shoulder pain. There are many reasons for shoulder pain that arent lung cancer.
Lung cancer is more likely to be the cause of your pain if youre a smoker and your pain:
- occurs during rest
- isnt associated with any strenuous activity involving the shoulder
- happens at night
- doesnt resolve itself after a few weeks
Your shoulder pain is also more likely to be a symptom of lung cancer if you have other lung cancer symptoms as well. These might include:
- shortness of breath, often mild and with activity
- a persistent cough
- losing weight without a reason
People who have shoulder pain from lung cancer often describe it as a radiating pain from the shoulder down their arms to their hands. There may also be numbness or tingling. At other times, it can feel like a deep ache.
Lung cancer frequently causes chest pain as well. Sometimes, this chest pain is a result of bouts of coughing.
In other cases, the pain of lung cancer is a result of a large tumor pressing on other structures or growing into the chest wall and ribs.
Tumors in the lungs can also press on blood vessels and lymph nodes. That causes a buildup of fluid in the lining of the lung, and it can cause pain or shortness of breath.
How Lung Cancer Can Cause Back Pain
Dr. Psallidas explains, Bone is a common site of metastasis in lung cancer. It is reported that approximately 1530% of patients with lung cancer will have bone metastases1.
Evidence shows that approximately 50% of lung cancer patients with bone metastasis have a spread of cancer cells to the spine2. Back pain could also be the first symptom that patients with lung cancer ever experience.
The back pain from lung cancer will not respond to conservative treatments that are prescribed for musculoskeletal back pain, such as exercises, stretching, yoga, heating pads, hot water massages and deep tissue massage.
It will not get better with rest or over time, and is not triggered by body position or physical activity.
Dr. Psallidas is the main author of many peer-reviewed publications and book chapters in pleural disease and lung cancer.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.
Top image: Freepik.com shayne_ch13
References1. Roodman GD. Mechanisms of bone metastasis. N Engl J Med 2004 350:165564. 10.1056/NEJMra030831. Can Cancer Cause Middle Back Pain?2. Michael Kuchuk, Christina L. Addison, Mark Clemons, Iryna Kuchuk, and Paul Wheatley-Pricea. Incidence and consequences of bone metastases in lung cancer patients. J Bone Oncol. 2013 Feb 2: 2229. How common is it
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The Course Of A Cancerous Spinal Tumor
Cancer is more likely to occur with age.3Xu Z, Taylor JA. Genome-wide age-related DNA methylation changes in blood and other tissues relate to histone modification, expression and cancer. Carcinogenesis. 2014 35:356-64. doi: 10.1093/carcin/bgt391. People who are older than age 50 or previously had cancer are at an increased risk of developing a cancerous spinal tumor.1Ziu E, Mesfin FB. Cancer, Spinal Metastasis. . In: StatPearls . Treasure Island : StatPearls Publishing 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441950/.
A cancerous spinal tumors rate of growth can vary depending on the type. A tumor may be relatively small and contained within the spine, or it could have already spread through blood or lymph from another area of the body. An untreated cancerous spinal tumor is likely to keep growing and may become life-threatening.
Treatment options for spinal cancer may include radiation therapy, chemotherapy, immunotherapy, and/or surgical removal of the tumor. In cases when the patient is unlikely to tolerate surgery well or has advanced cancer, palliative care may be offered to reduce pain and stay as comfortable as possible, rather than removing the tumor.
The Link Between Shoulder Pain And Lung Cancer
People who get shoulder pain may worry about it being caused by lung cancer. While this is possible, its much more likely that your shoulder pain is caused by something like an injury, tendonitis, or arthritis. Your doctor can help you determine the cause of your pain.
Shoulder pain can be a symptom of lung cancer from early through late stages of the disease.
Read on to learn about the types of lung cancer that can cause shoulder pain.
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Whats The Connection Between Lung Cancer And Back Pain
There are many causes of back pain. In some cases, this common complaint could be due to minor injuries or strains. And while back pain may not be one of the first symptoms that come to mind as an indicator of lung cancer, the Roy Castle Lung Cancer Foundation notes that it could be just that.
If you are experiencing long-term back pain, you may want to consider if you have any co-occurring symptoms that could also be signs of lung cancer. Other common symptoms include respiratory issues, like hoarseness, coughing up blood , and shortness of breath , as well as irregular head, shoulder, or chest pain. If you are experiencing back pain that persists for longer than a few days, its always best to connect with your health care team.
Is Shoulder Pain A Sign Of Lung Cancer
Sharp shoulder or scapula pain are some of the most common symptoms of a Pancoast tumor, particularly in its early stages. The pain typically develops as the tumor impacts one or more of the nearby structures, such as the:
- Ulnar nerve, which runs from the side of the arm to the wrist
- Branchial plexus, the nerve fibers that run downward from the spine and into the shoulder and arm
- Parietal pleura, the highly sensitive outer layer of the membrane that lines the chest cavity.
- Endothoracic fascia, the fibrous tissue that separates the chest wall from the diaphragm and the pleura
Shoulder pain can be a symptom of other lung cancers besides Pancoast tumors, typically if a lung tumor presses against a particular nerve or if the cancer travels to the tissues or bones near the shoulder joint.
Its important to note that shoulder pain is far more likely to be caused by an orthopedic condition, such as osteoarthritis or a rotator cuff injury, than lung cancer. Nevertheless, shoulder pain that persists for more than a few days should be evaluated by a medical professional. Shoulder discomfort that is related to lung cancer may worsen at night, be present while resting or occur without impacting range of motion. Lung cancer that is not classified as a Pancoast tumor may also cause a hacking cough, shortness of breath and wheezing, among other respiratory symptoms.
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Face And Neck Swelling
Lung cancer tumors can press on the large blood vessel that returns blood to the heart from the upper part of the body .
When this happens, it causes the blood flow to that vein to become fully or partially blocked. This is called superior vena cava syndrome.
If the blood flow is blocked, pressure builds up in the areas the vein is supposed to drain blood away from. This can cause swelling of the face, neck, and arms. A person may also have veins in the neck and chest that look bigger than normal .
Treatment For Shoulder Pain From Other Causes
If your shoulder pain isnt due to lung cancer, its important to determine the cause. This will help your doctor come up with a treatment plan.
For example, they may recommend physical therapy if you have shoulder pain due to tendonitis.
If you have shoulder pain due to frozen shoulder , your doctor may recommend a combination of glucose-lowering drugs and a low carbohydrate diet.
You can manage shoulder pain properly if you deal with its underlying cause. If your doctor diagnoses you with lung cancer, its important to get the best treatment available.
You can try home treatments for your shoulder pain while youre waiting to see your doctor:
- Avoid using your injured shoulder.
- Try icing your shoulder for 15 to 20 minutes at a time. This may help reduce pain and swelling.
- Try wrapping your shoulder with an elastic bandage. Using compression can help you avoid overusing your shoulder.
- Elevate your shoulder above your heart as much as possible. You can use pillows to help you with this.
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You May Already Know That Lung Cancer Can Cause Back Pain But Just How Often Or Common Is This
After all, back pain is one of the leading reasons for visits to primary care physicians and is Americas No. 1 nonfatal health problem.
Lung cancer may not produce any noticeable symptoms in the early stages, and many people are not diagnosed until the disease has advanced, says Ioannis Psallidas, MD, PhD, Honorary Consultant Respiratory Physician, Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, who has a focus in thoracic oncology.
When we think about back pain, usually the last thing that comes to mind is cancer, continues Dr. Psallidas.
Linking the back to the lungs it might be an unusual association. However, it is not uncommon for people to experience back pain with lung cancer.
