Pain is a funny thing. Well, okay, not actually laughing funny, but more of the quirky funny. The fact that it can bring us to our knees, stop us in our tracks and make us ask some genuinely terrifying questions about our health is quite something.
Perhaps one of the biggest questions about back pain is: Do I have “The Big C”?
This blog takes a look at some of instances where cancer and low back pain are connected and when it is less likely to be something you need to worry about. Ready to learn more? Read on!
Could It Be Cancer?
When pain feels so intense, we naturally assume that there must be something really serious going on. Low back pain is one of those conditions that can bring about some really intense experiences of pain. It brings our lives to a grinding halt sometimes, and causes us to miss out on work and social events.
The good news is that, while low back is a very common condition (it is one of the most common reasons people seek medical attention from their primary care doctor), it is very rarely a sign of cancer.
Cancer And Low Back Pain
Cancer is a very rare cause of low back pain. In fact, the lifetime chance of developing a spinal cord tumor is less than 1%. Most cases of low back pain stem from things like overuse, age-related changes in our spine (arthritis), or injuries from sporting or car accidents.
It is also possible to have low back pain as a result of some types of cancer, such as spine cancer, colorectal cancer, or ovarian cancer. We will discuss some of these cancers later, but generally they will go along with other signs and symptoms - not just back pain.
So, while the odds are in your favor that most cases of low back pain are simply low back pain, and not something far more scary, it is always a good idea to be able to recognize some of the symptoms that might point to cancer. When it comes to any type of condition, early detection is vital in making a significant difference to outcomes.
Symptoms Of Back Pain-Related Cancer
For some reason, as humans we tend to correlate the intensity of the pain with the severity of the condition. If the pain feels really bad then it must be something super serious! Ironically, this is not often the case.
Back pain doesn’t have to be severe for it to indicate cancer. One of the biggest indicators of cancer in low back pain patients is actually a previous history of cancer. Any type of previous experience of cancer is one of the biggest red flags for physicians.
If you have back pain and you think that it could be cancer, you should consider the red flags associated with low back pain, evaluate your specific history and symptoms and then schedule a visit with your healthcare provider.
Some key symptoms of back pain-related cancer:
Back pain that doesn’t get worse when you move around
Back pain that doesn’t go away with physical therapy or other commonly used treatments.
Any changes in your bowel movements.
Back pain that happens mostly at night, and that disappears during the day.
Fatigue
Unexplained weight loss
Any tingling or numbness in your arms or legs.
What Types of Cancer Can Cause Low Back Pain?
So, what sort of cancers can cause low back pain? There are several types of cancer that can cause pain in the lower back. Blood cancers, ovarian cancer, kidney cancer, and thyroid cancer can all be causes of back pain.
Let's look at some of the most common cancers associated with this condition.
1. Spinal Tumor
Spinal tumors can be primary or secondary, meaning that the cancerous tumor originates in the spine or, in the case of secondary tumors, the spine is a source for bone metastasis, where the cancer started in a different location and has now spread to a bone - in this instance the spine.
Primary spinal tumors are rare, while the American Association of Neurological Surgeons (AANS) believes that between 30- 70 percent of cancer patients will have their cancer spread to their spine.
Spinal tumors tend to grow either in the spinal cord and column, or they grow around it, in the protective membranes. Tumors can be either benign (noncancerous) or malignant (cancerous) but either way, a tumor can put pressure on the nerves of the spinal column, causing pain.
Types Of Spinal Tumors
Spinal tumors can be broken down into two types, depending on the proximity to the spinal cord, and their location to it.
Basically there are two types: Intramedullary tumors and Extramedullary tumors. Around 20-30% of tumors are intramedullary, meaning that they grow inside the spinal cord. These are the types that most often cause back pain that feels worse when you lie down and put pressure on the spinal cord.
Extramedullary tumors most often cause back pain that radiates to the legs and arms and feels worse at night. These tumors occur most often outside the spinal cord, inside the extending nerve roots.
Your doctor can order imaging tests like a CT scan or an MRI to see if you have a spine tumor. They can also order blood tests or perform a biopsy of the suspected mass to confirm if it is a tumor and if it is malignant or benign. They might also perform a neurological exam to see if there is any nerve damage present.
2. Lung Cancer
One of the most common cancers that spreads to the spine is lung cancer. Lung cancer accounts for a large majority of cancer cases. The American Cancer Society predicts that almost 250,000 people will be diagnosed with the disease this year and some 130,000 will die from it. Lung cancer is also the leading cause of cancer death in the world.
Lung cancer not only affects the lungs but it can also metastasize (spread) easily to other parts of the body. In 30-40% of patients, lung cancer will metastasize, and the spine is one of the most common sites that is affected.
Tumors that occur in the lungs can press on the spine, causing issues with nerve transmissions to the lower back and increasing sensations of pain.
Symptoms of lung cancer:
Fatigue
Shortness of breath
Wheezing
Coughing up blood or blood-tinted phlegm
Loss of appetite
Unexplained weight loss
A persistent cough
Chest pain
Recurring bronchitis or pneumonia
3. Breast Cancer
Breast cancer is another type of cancer that is more common and that also often metastasizes to the back. Back pain is not a typical symptom of breast cancer but it can happen in rare instances.
Most of the time, breast cancer is identified by the presence of a lump in the breast tissue, but there have been some rare cases where back pain was the first symptom that led to the diagnosis.
Just like with lung cancer, if a tumor in the breast presses on the nerves that lead to the spine, there can be increased sensations of pain. If you have any of the following symptoms along with your low back pain you should definitely make an appointment with your doctor to have a full check up.
Symptoms of breast cancer:
Breast or nipple pain
Nipples that turn inwards
Nipple discharge
Breast skin or nipple that is red, dry, flakey
Swollen lymph nodes
Breast rash
Changes in the shape, size of appearance of the breast
Changes in the skin over the breast, like swelling or dimpling
Redness or pitting of the breast skin (orange peel skin)
Lump of mass in the breast that feels different from the surrounding tissue.
4. Gastrointestinal Tract Cancer
There are several cancers that are associated with the gastrointestinal tract. These include stomach cancer, colon cancer and rectal cancer. All of these can cause low back pain as the pain radiates out from the site of the cancer to the lower back.
Again, back pain is not the most common symptom associated with these types of cancer, but it should be evaluated further, especially if you have a history of cancer.
Symptoms of GI Tract Cancer:
Unexplained and sudden weight loss
Rectal bleeding with bright red blood
Dark blood (occult blood) in the stool
Feeling of incomplete bowel movements
Changes in bowel habits (new diarrhea, constipation)
Fatigue
Poor appetite
Abdominal pain/cramping
Nausea
Heartburn
Vomiting
Swelling of the abdomen (fluid build-up)
5. Melanoma
Melanoma is the most serious type of skin cancer and it can develop anywhere on your body. Fortunately melanoma is fairly rare but if it goes undetected it can quickly spread to other parts of the body, including the spine.
Regular check ups with your dermatologist or doctor can help catch melanoma in the early stages, which is much easier to treat and has a high recovery rate. If you have any of the following symptoms then you should definitely make an appointment with your doctor.
Symptoms Of Melanoma:
Changes to the look of an existing mole (border, color, shape)
Development of new, unusual growths on your skin
Sores that don’t heal
Redness or swelling beyond the border of your mole
Itchiness, pain or tenderness of the mole
Oozing, bleeding, scaliness of the mole
6. Blood Cancers
Blood cancers like lymphoma, leukemia and myeloma affect the bone marrow and rarely present with back pain as a stand alone symptom. If you are experiencing any additional symptoms, along with your low back pain, you should set up an appointment with your healthcare provider and give them a history of your symptoms.
Symptoms Of Blood Cancers:
Unexplained weight loss
Bruising
Fatigue
Diarrhea
Shortness of breath
7. Prostate Cancer
Prostate cancer is another very common type of cancer. Fortunately this cancer develops fairly slowly and is therefore often very treatable.
If prostate cancer goes undetected and it becomes advanced then it can spread to the bones such as the ribs, hips and spine. Back pain is not typical but it can occur.
Symptoms:
Blood in the urine or semen
Weakness or numbness in the legs or feet
Loss of bladder or bowel control
When Should You See Your Doctor?
If you have read through all of this information and are worried that you might have some symptoms related to any of these cancers, you should definitely make an appointment with your healthcare provider to discuss your concerns. You should also see your doctor if you have:
A history of cancer
You can feel a lump in your spine
Your back pain isn’t due to an injury or movement-related
Your back pain has started suddenly
Conclusions
While the thought of having cancer is extremely scary and concerning, it is good to remember that statistics show that less than 10 percent of spinal tumors actually start in the spine.
It is also good to remember that even if the doctors discover a tumor in your spine, it doesn’t mean that it is cancerous- it could be a benign tumor and be easily removed.
By paying attention to the symptoms you are experiencing and discussing your concerns with your healthcare provider right away, your cancer might be very treatable.
When it comes to cancer, early detection and intervention is always a good thing and can make a significant difference to the outcome of the disease.