Back pain
Spread of cancer to the bone or spinal cord can lead to back pain. Bone is one of the most common sites of metastatic lesions. Patients typically have a history of malignancy. Common types of cancer that present with back pain include multiple myeloma, lymphoma, leukemia, spinal cord tumors, primary vertebral tumors, and prostate cancer. Back pain is present in 29% of patients with systemic cancer. Unlike other causes of back pain which commonly affect the lumbar spine, the thoracic spine is most commonly affected. The pain can be associated with systemic symptoms such as weight loss, chills, fever, nausea and vomiting. Unlike other causes of back pain, neoplasm-associated back pain is constant, dull, poorly localized, and worst with rest. Metastasis to the bone also increases the risk of spinal cord compression or vertebral fractures which requires emergent surgical treatment.