The 7 Warning Signs Of Bone Cancer You Shouldn't Ignore

Although it is rare, bone cancer is a serious health concern that affects thousands of people annually. In 2024 alone, there were 3,970 new diagnoses among both adults and children in the United States (per American Cancer Society). Primary forms of this disease that originate in the bone itself represent fewer than 1% of cases. Patients mainly experience bone metastasis, which develops when the cancer cells migrate to the bone from another affected site.

There are three common types of bone cancer, according to the Mayo Clinic: osteosarcoma, Ewing sarcoma, and chondrosarcoma. The former is the most commonly diagnosed, and while it typically affects younger adults, it may also occur in people over the age of 65, usually as a secondary cancer. Diagnosis of any type of bone cancer typically involves both imaging and biopsies. Since symptoms of bone cancer can sometimes mimic those of less severe conditions, these tests can rule those out.

Patients may experience a variety of symptoms, many of which they may not necessarily equate with something as serious as cancer. Persistent pain, tenderness, and exhaustion are all common effects. According to the American Cancer Society, "most bone cancers are found at an early stage." The likelihood of catching the disease early increases if you're mindful of seven key warning signs that may indicate the presence of cancer. Recognizing these, and taking quick action to receive a diagnosis and subsequent treatment, may make all the difference to your prognosis.

Pain of any kind can be distressing, but it doesn't usually lead people to suspect bone cancer. However, it's good to be aware of pain that lingers in one area and doesn't improve with time. Understanding the difference between "regular" pain and cancerous pain is important, explained Salil Patkar, M.D., an oncologist at Fortis Hiranandani Hospital, to Only My Health. "Normal bone pain usually arises from minor injuries or overuse and improves with rest and time. Cancer-related bone pain, however, may persist, worsen, or occur at rest. It can be severe, often waking the person from sleep."

Per Hartford HealthCare of St. Vincent's Medical Center, pain may fluctuate before it progresses to something more persistent. Adam Lindsay, M.D., who's an orthopedic oncologist and a surgeon at Hartford Hospital, said that most bone cancer diagnoses are metastatic and that the likelihood of pain alone being a type of bone cancer is slim. "We diagnose 5,000 or less primary bone cancers in the U.S. annually, which makes it one of the rarest cancers we treat," he noted.

Pain that is related to bone cancer may also present with other symptoms, like a lump on the affected area and inflammation. The bone may even develop a fracture as it grows weaker. It's never a bad idea to get checked out, as your primary care doctor can send you for further testing if they suspect there's a reason to rule out bone cancer.

Limited mobility can make performing ordinary tasks difficult. Usually, difficulty moving is the result of an injury or the effects of aging. There are many conditions that can affect mobility, from arthritis to movement disorders like Parkinsonism and Lewy body dementia, according to the Cleveland Clinic. 

If cancer metastasizes, though, it may weaken the affected bone, leading to brittleness and impairing the ability to move. If the disease progresses to stage 4, it is no longer localized. As it spreads to other parts of the body, it can also lead to a significantly reduced ability to move (per Medical News Today). As bone tumors grow, they can invade the surrounding tissues, leading to increased pain and consequently causing the affected bone to weaken further. That, in turn, can also affect mobility. 

According to physical therapist Crystal Vendrell of the Banner MD Anderson Cancer Center, even treatments for primary bone cancer may have an effect. "Surgical side effects can result in decreased range of movement, decreased flexibility, muscle weakness, decreased balance, difficulty walking and difficulty with activities of daily living," she said

Patients who have another primary cancer that has spread to their bones may also experience difficulty moving. Bone metastases can weaken the structural integrity of the bone, causing symptoms like pain and an increased risk of developing fractures. This can lead to a limited range of motion or decrease mobility entirely, especially if the metastasis develops in a weight-bearing part of the body, like the spine, legs, or pelvis.

Tenderness and swelling can be symptoms of bone cancer, developing at the site of the tumor. A swollen area can fluctuate with pain that gradually worsens as the cancerous cells grow in the bone. This can lead to persistent inflammation and a visible lump that forms in the affected area. While the swelling might go unnoticed at first, especially if it occurs deep in the bone, it may grow more irritated as the tumor itself grows and affects surrounding tissues and muscles. Swelling can also make the area feel stiff, affecting your movement and overall comfort.

In some cases, the swelling is accompanied by pain. This may worsen with activity or at night. The symptom may be especially noticeable if the tumor is located near a joint, as the pressure can make movement even more challenging. Swelling in the legs or arms, for example, can severely hamper range of motion and make it difficult to perform everyday tasks. Additionally, bone cancer that affects those bones nearer to the surface of the skin, an uncommon form of the disease called "surface bone sarcoma," might also lead to more prominent swelling.

Unfortunately, swelling associated with bone cancer can sometimes be mistaken for other conditions, such as arthritis or a sports injury. This can delay diagnosis, which is why it's crucial to see your medical provider if you have swelling — especially if it is accompanied by persistent pain that does not resolve over time.

Fatigue is a common symptom of all types of cancer, leading to effects like chronic exhaustion and a general lack of energy. Sometimes that fatigue is due to cancer treatments, like chemotherapy, radiation, and surgery (per American Cancer Society). However, fatigue can also be a symptom of bone cancer itself — which is why it's crucial to see a doctor to rule it out if your exhaustion persists without explanation.

Alexandra Olivier, M.D., who is an associate clinical director at Bupa Health Clinics, told the Independent, "There are many medical conditions that can cause fatigue, but it could be a symptom of cancer. If you've noticed you're feeling constantly fatigued and it's preventing you from working, or carrying out your daily activities, you should mention this to your GP, who may consider further investigations."

Depending on the location and severity of bone cancer, it may cause significant tiredness, to the point where performing even routine tasks — like showering, getting dressed, or preparing a snack — can feel especially exhausting. According to Verywell Health, fatigue related to bone cancer can't usually be resolved simply by taking a break or resting. According to the National Cancer Institute, cancer feeds on the nutrients and calories you normally use to fuel your day. It's theorized that the release of excess cytokines, proteins that normally manage inflammation, may also lead to this feeling of uncontrollable fatigue.

Although it's rare, some bone cancer patients may develop what's known as a "pathologic fracture." This type of broken bone develops when the cause is linked to an underlying condition of some type. That's in contrast to "conventional" fractures that might occur as a result of a sports injury or an accident, for example. Bone cancer can weaken the bone so significantly that it may break even when exposed to something as seemingly mild as the pressure of body weight, per the Department of Neurosurgery at Columbia University Irving Medical Center.

Usually, pathologic fractures are found in patients for whom cancer has metastasized to the bone. In fact, this may be a primary symptom of metastasis. Research from 2015 published in Bone Cancer found that among 1,800 patients, 8% experienced a pathologic fracture, and half of those cases were attributed to breast cancer. While fractures can develop anywhere, they're more likely to affect the pelvis, spine, arms, and legs, and cause a significant amount of pain. Per Cleveland Clinic, fractures that affect the limbs will inhibit movement.

Naturally, a broken bone can dramatically affect quality of life, due to both limited mobility and extreme discomfort. Doctors generally opt for conservative treatment measures, such as medication and bracing the affected bone. However, some cancer patients might benefit from a bone cement injection. This solution fills the gaps in the bone to improve its structural integrity.

Unexplained weight loss may be an indication that a person has bone cancer. There are several factors that could be to blame for this. One may be that the presence of cancer cells leads to an "increased metabolic rate" (per Medical News Today). The faster one's metabolism, the more difficult it is to maintain a normal weight. Individuals with bone cancer may also have a loss of appetite as the cancer cells proliferate. Additionally, older 2001 research published in PNAS found that pain itself may also reduce appetite.

There's also evidence that the treatment for bone cancer may affect a person's appetite. Chemotherapy administered to treat osteosarcoma, for example, can alter the way foods taste and inhibit normal nutrient digestion. That can have a long-term effect on a patient's appetite, as a lack of flavor could impact the patient's desire to eat.

Plus, per the Children's Cancer and Leukaemia Group (CCLG), a lower body weight requires doctors to administer less chemotherapy — which could, in turn, affect the quality and efficacy of treatment. That could further impact appetite. 

It can be a frustrating cycle for cancer patients and their families. To provide some relief and to improve the patient's nutrition, doctors may in some cases elect to use a feeding tube to administer nourishment via the nose directly to the stomach.

Some patients with bone cancer might develop a side effect known as a "neoplastic fever." This is a fever that is specifically caused by the presence of cancer cells. A key symptom of a fever is sweating, which is the body's natural response to the sudden spike in temperature — sweat develops in an effort to cool the body down.

Sometimes patients may also develop night sweats. While night sweats can occur for a number of reasons, such as menopause or hyperhidrosis (a condition that causes excess sweating), people with bone cancer may experience a significant amount of night sweats. According to Prevention, it's far more disruptive than "ordinary" sweating that might occur at night. A person with bone cancer might have night sweats that soak through their clothing, for example, leaving them drenched in moisture.

However, there's a caveat. Arianna Sholes-Douglas, M.D., a gynecologist, told Prevention that people who experience this degree of night sweating are usually accompanied by other hallmark symptoms in people who have bone cancer, "such as fever and unexplained weight loss." Bear in mind that not all fevers cause sweating, though. If a patient has a neutropenic fever (a fever accompanied by low white blood cells), there may not be as many symptoms as a conventional fever, according to the American Cancer Society.