Why Do Some People With Cancer Experience Back or Bone Pain?

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Why Do Some Cancers Cause Bone Pain?

Bone pain/weakening can be a symptom of certain cancers or treatments
It can also be an indicator that cancer has spread from another organ into the bones
In many cases, there are medications and other therapies available to both alleviate pain and to help strengthen bones

Bone pain, particularly in the back, has been associated with several cancers and cancer treatments. While this pain can be due to a whole host of issues — from poor posture to a minor injury — people living with cancer should inform their doctors about any new or lingering pain in the bones or joints.

Cancers Associated With Bone Pain/Loss

Pain in the bones, particularly in the spine, can be a sign that cancer has spread. When cancer has spread from one organ to another this is called a metastasis. Specifically, when cancer has spread from one organ (such as the lung) to the bone this is called a bone metastasis. Another way cancer can cause bone pain is if the cancer starts in the bone or the bone marrow. Although much less common than a bone metastasis, cancers of the bone — such as osteosarcoma — or of the bone marrow — such as multiple myeloma — can cause significant bone pain and bone weakness.

These diseases cause bone damage or loss in the majority of patients, typically in the spine, pelvis and rib cage.

In myeloma, the reason for this bone damage is that the disease disrupts the bone remodeling process. For instance, cancerous myeloma cells keep cells in the bone that are responsible for removing old bone and replacing it from working properly. This can cause bone pain, weakness, and damage.

Dr. Jens Hillengass, of Roswell Park Comprehensive Cancer Center, explains how multiple myeloma is diagnosed.

The disease may also weaken the bones or cause them to thin, which is called osteoporosis. In advanced multiple myeloma, a patient may even become shorter, loosing inches from their height due to compressed vertebrae over the course of the illness.

When Cancer Spreads to the Bone

The most common cancers that spread to the bone are breast, lung and prostate cancers. While this does indicate that a disease has progressed to stage four, there are often still treatment options available.

People who have had cancer in the past should be aware of any new aches or pains. The most common indicator that cancer has spread to the bone is pain. In most cases, the pain is localized to a specific spot — but sometimes it can feel more like general aching.

A common spot for cancer to metastasize to is the spine, which often causes back pain. Cancer can also spread to other bones like the hips or the shoulders.

Treatment for metastatic cancer in the bones will depend on what kind of cancer you have, if it spread to more than one spot in the bones, and what kind of treatment you have already undergone.

The American Society of Clinical Oncology (ASCO) notes that there are several treatment approaches your doctor may take with these metastatic cancers:

Bone-modifying drugs — These drugs can slow bone thinning, reduce pain and decrease a condition called hypercalcemia, where there is too much calcium in the blood.
Radiation Therapy — This treatment may be used if cancer has spread to the bones in order to quickly relieve symptoms of pain and help with stability. Sometimes after surgery to stabilize a fracture, radiation may be used to help with pain and eliminate any cancer cells left after surgery.
Surgery — This can be used to remove a tumor or to treat or prevent a bone fracture. Surgery is also used to stabilize bones where cancer has spread. Often times radiation is used after surgical stabilization to prevent cancer from returning to the same spot.
Doctors may also use chemotherapy, hormone therapy or other drugs if bone metastases are found in multiple areas throughout the body

There are also several integrative techniques that doctors may suggest for patients dealing with bone pain. Some practices/medications that may help to increase bone strength and help with pain include:

Supplements Your doctor may recommend taking calcium or vitamin D supplements, both of which help maintain bone health. You should discuss all supplements with your doctor before taking them as certain supplements may interfere with chemotherapy or radiation therapy.
Exercising Staying active particularly by doing weight-bearing exercises like walking, dancing, walking stairs or using an elliptical can help the body and strengthen bones. The level of physical activity a person can engage in will vary from patient to patient and should be discussed with your doctor. Sometimes patients can work with a physical therapist to ensure that weight-bearing exercises are done safely.
A Healthy Diet Making sure you maintain a balanced diet is important for overall bone health, and being underweight may increase a person's risk of bone-related problems.
Other healthy habits such as limiting alcohol intake and quitting smoking can also help improve your bone health.

Dr. Elizabeth Comen, a breast oncologist at Memorial Sloan Kettering Cancer Center, explains how exercise can help women tolerate breast cancer treatment better.

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