Knee Pain May Be the First Sign of Lung Cancer (2023)

Knee pain and lung cancer may not be what you commonly think of when joint pain symptoms occur, but knee pain can be a sign of lung cancer in very rare instances.

It's common to see a healthcare provider for knee pain, but you may want to discuss a cancer screening even if you don’t have a cough, weight loss, or “typical” signs of lung cancer. That's especially true for people at high risk of lung cancer because of smoking, genetics, environmental exposure, or even their male gender at birth.

This article explains some of the reasons for why knee pain may be a sign of lung cancer and how this diagnosis is made. It also briefly presents a few of the treatment options for lung cancer.

Knee Pain May Be the First Sign of Lung Cancer (1)

How is Knee Pain Related to Lung Cancer?

Knee pain and lung cancer may be linked in a few ways. The pain may occur if a tumor metastasizes, or spreads, to connective tissue areas, or it may be the result of unusual complications associated with lung cancer. This is how lung cancer can spread to the knee.

Metastases

Lung cancer is most commonly associated with metastases to the brain, lymph nodes, liver, and adrenal glands, but it can spread almost anywhere, including the synovial tissue. This is a type of connectivetissuein the protective membranes surrounding the body’s joints.

When lung cancer metastasizes to these areas of the body, it is usually a lung adenocarcinoma. The joints most likely to be affected are the knees.

When the knee is impacted in this way, symptoms may include:

  • Pain
  • Swelling
  • Decreased ability to stand
  • Impaired ability to straighten the knee

Surgery to remove the entire tumor is usually the first course of treatment for cancer in the synovial tissue. Chemotherapy may also be recommended to increase the chances of eliminating all of the malignant cancer cells.

How Lung Cancer Spreads

Paraneoplastic Syndromes

People with lung, ovarian, lymphatic, or breast cancer are at risk of developing paraneoplastic syndrome, a rare complication in which cancerous tumors cause organ or tissue damage that can trigger the production or release of hormones or other chemicals. Paraneoplastic syndromes affect approximately 10% of all people with lung cancer.

Paraneoplastic syndromes are thought to happen when cancer-fighting antibodies or white blood cells (known as T cells) mistakenly attack normal cells, especially in the nervous system or the endocrine (hormone) system.

Rheumatic and neurologic tissue are among the most commonly affected by paraneoplastic syndromes related to lung cancer.

(Video) Symptoms of lung cancer

Hypertrophic Pulmonary Osteoarthropathy (HPOA)

This rare type of paraneoplastic syndrome can be the first sign of knee pain linked to lung cancer. Substances secreted by a lung tumor or made by the body in response to a lung tumor can cause swelling and inflammation.

Signs of HPOA (sometimes called HOA) may include:

  • Painful inflammation and swelling in the knees, as well as the ankles, wrists, and elbows
  • Clubbing (swelling of the ends of the finger)
  • Koilonychia (spoon-shaped nails)

Once the tumor is removed, the knee pain or other symptoms related to HOA should improve. Treatment may also include nonsteroidal anti-inflammatory drugs (NSAIDs) or bisphosphonates, medications typically prescribed to treat osteoporosis.

Knee Pain as a Symptom of Lung Cancer

Both monoarthritis (pain in one joint) and polyarthritis (pain in multiple joints) have been identified as possible signs of lung cancer. Sometimes, these symptoms can be misdiagnosed.

The connection between knee pain and lung cancer can easily be missed because the rate of arthritis problems occurring with lung cancer is very low.For example:

  • Arthritis symptoms due to a paraneoplastic syndrome occur in approximately 0.24% of lung cancer patients.
  • HPOA incidents among lung cancer patients range from 0.72% to 17%.
  • Researchers have only reported 48 cases of synovial metastasis, and only a fraction of those incidents are related to knee pain.

If you have lung cancer, your knee pain is more likely to be related to other causes and is rarely a symptom of your lung cancer.

If you have rheumatoid arthritis (RA), your knee pain is likely related to your arthritis. However, you should discuss your risk of lung cancer with your healthcare provider. Those with RA are eight times more likely to develop interstitial lung disease, which puts you at risk for lung cancer.

Diagnosis

If you have lung cancer and knee pain, your healthcare provider will first look for the obvious causes of joint disease or injury.

The connection between knee pain and lung cancer may only be found if your pain persists or if your discomfort spreads to other joints.

If you haven't been diagnosed with lung cancer, you might get tested for any of the following reasons:

  • You have signs of a paraneoplastic syndrome, such as clubbing
  • X-rays of your knee are concerning
  • Your joint pain doesn't respond to treatment

Computed tomography (CT) scan of the chest and a biopsy of the lung may be ordered to confirm a cancer diagnosis.

How is Lung Cancer Diagnosed?

Treatment Options

If lung cancer is identified as the cause of your knee pain, your treatment will focus on removing or reducing the size of your tumor via surgery, chemotherapy, and/or radiation.

(Video) Lung Cancer Warning Signs II Lung Cancer Symptoms

The type of surgery and the course of chemotherapy and radiation will depend on where the tumor is located, its size, and its type.

Your healthcare provider may also prescribe steroids, high-dose intravenous immunoglobulin, or irradiation.

Surgery, Chemotherapy, Radiation, and Other Lung Cancer Treatment Options

A Word From Verywell

Lung cancer incidence and treatment have changed over the years. Today, young never-smokers, notably women, are developing the disease more often. Vague symptoms may occur before classic symptoms.

If your knee hurts or other unusual health symptoms arise, talk with your healthcare provider. It's better to get checked out and determine the root cause as soon as possible.

Frequently Asked Questions

  • Can lung cancer cause leg pain?

    Yes, lung cancer can affect the joints and long bones of your legs, and lead to pain in rare cases. While uncommon, this link to knee and leg pain also has been reported in people with cancers affecting other parts of the body, including kidneys.

    Learn More:Different Types of Cancer

  • Is joint pain a symptom of lung cancer?

    (Video) Top 5 Signs Your Shoulder, Hip, or Knee Pain, Is NOT Arthritis

    It can be, especially if the cancer has spread. But with knee pain and lung cancer, your pain is more likely to be related to other causes. Your healthcare provider can help to diagnose your pain and evaluate your risk of lung cancer.

    Learn More:Joint Pain Causes and Treatment Options

10 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Levine HR, Tingle E, Carter B, Dockery D. Synovial metastasis from lung cancer. Proc (Bayl Univ Med Cent). 2013;26(1):25-7. doi:https://doi.org/10.1080%2F08998280.2013.11928905

  2. Outani H, Kakunaga S, Hamada K, et al. Favorable outcomes of localized synovial sarcoma patients with a high utilization rate of neoadjuvant and/or adjuvant chemotherapy. Mol Clin Oncol. 2019;11(2):151-156. doi:10.3892/mco.2019.1863

  3. Kanaji N, Watanabe N, Kita N, et al. Paraneoplastic syndromes associated with lung cancer. World J Clin Oncol. 2014;5(3):197-223. doi:10.5306%2Fwjco.v5.i3.197

  4. National Institute of Neurological Disorders and Stroke. Paraneoplastic syndromes information page.

  5. Kumari P, Yeung P, Medani A, Kiani AN. Hypertrophic pulmonary osteoarthropathy: an unusual presentation. Rheumatol Adv Pract. 2018;2(1):rky009. doi:10.1093/rap/rky009

  6. Syniachenko O, Іermolaieva I, Stepko P, Verzilov S, Potapov Y. Paraneoplastic rheumatoid-like arthritis associated with lung cancer. Pain Joints Spine.2020;10(1). doi:10.22141/2224-1507.10.1.2020.199724

  7. Fang YH, Hsu CC, Hsieh MJ, Hung MS, Tsai YH, Lin YC. Impact of hypertrophic pulmonary osteoarthropathy on patients with lung cancer. Onco Targets Ther. 2017;10:5173-5177. doi:10.2147/ott.s139558

  8. Kakutani T, Hashimoto A, Tominaga A, et al. Related factors, increased mortality and causes of death in patients with rheumatoid arthritis-associated interstitial lung disease. Mod Rheumatol. 2020;30(3):458-464. doi:10.1080/14397595.2019.1621462

  9. MedlinePlus. Lung cancer - non-small cell.

    (Video) 8 Signs that You have Cancer

  10. Oh KS, Lee SY, Min SH, Ryu C, Shin HY. Hypertrophic osteoarthropathy in renal cell carcinoma - A case report. Anesth Pain Med. 2021 Jul;16(3):290-294. doi:10.17085/apm.20092

(Video) Lung Cancer - All Symptoms

FAQs

Can lung cancer make your knees hurt? ›

This rare type of paraneoplastic syndrome can be the first sign of knee pain linked to lung cancer. Substances secreted by a lung tumor or made by the body in response to a lung tumor can cause swelling and inflammation. Once the tumor is removed, the knee pain or other symptoms related to HOA should improve.

What part of the body hurts when you have lung cancer? ›

Lung cancer may produce pain in the chest, shoulders, or back. This can happen when you cough or throughout the day. Tell your doctor if you notice any type of chest pain and whether it's: sharp.

What cancer makes your knees hurt? ›

Certain types of cancer are more likely to cause joint pain. Cancer that occurs near or in a joint, such as bone cancer and cancer that spreads to the bone, can cause joint pain. Lung cancer, breast cancer, prostate cancer, and multiple myeloma are more likely to involve and spread to the bone.

What is knee pain caused by? ›

The most common causes of knee pain are related to aging, injury or repeated stress on the knee. Common knee problems include sprained or strained ligaments, cartilage tears, tendonitis and arthritis.

What are the signs of knee cancer? ›

swelling and redness (inflammation) over a bone, which can make movement difficult if the affected bone is near a joint. a noticeable lump over a bone. a weak bone that breaks (fractures) more easily than normal. problems moving around – for example, walking with a limp.

What are some unusual symptoms of lung cancer? ›

Unexpected Signs and Symptoms of Lung Cancer
  • Arm/shoulder pain or eye problems. One kind of lung cancer (called a Pancoast tumor) develops in the lung's upper part. ...
  • Hoarseness or change in voice. ...
  • Balance problems. ...
  • Weight. ...
  • Blood clots. ...
  • Bone pain. ...
  • Clubbed fingers – fatter fingers. ...
  • Digestive problems.

Where does lung cancer usually start? ›

Lung cancers typically start in the cells lining the bronchi and parts of the lung such as the bronchioles or alveoli. A thin lining layer called the pleura surrounds the lungs.

Where does lung cancer spread first? ›

Most lung cancers first spread to lymph nodes within the lung or around the major airways.

What does lung cancer feel like in the beginning? ›

In its early stages, lung cancer doesn't typically have symptoms you can see or feel. Later, it often causes coughing, wheezing, and chest pain. But there are other, lesser-known effects that can show up, too -- in places you may not expect.

Can you feel early lung cancer? ›

Sometimes it doesn't feel like anything at all. Because lung cancer doesn't typically cause pain or other warning signs in its early stages, many people don't realize they have the disease.

How is lung cancer detected early? ›

For lung cancer, early-detection screening by a low-dose computed tomography (LDCT) scanA form of CT scan that uses less radiation than a standard chest CT (also called low-dose spiral CT scan or helical CT scan) has proven to be effective among individuals considered to be at high risk.

Can bone cancer start in the knee? ›

Chondrosarcoma primarily affects the cartilage cells of the femur (thighbone), arm, pelvis, or knee. Although less often, other areas (such as the ribs) may be affected. Chondrosarcoma is the second most common type of primary bone cancer. A primary bone cancer is one that starts from bone.

Does lung cancer cause joint pain? ›

HPOA most often causes inflammation of bones and joints in the wrists and ankles. Sometimes this shows up on bone scans or x-rays. Ankles and wrists can become swollen and inflamed, causing a lot of pain and difficulty with movement. One of the most common symptoms of HPOA is a condition known as clubbing.

Can you get cancer in your knees? ›

Primary bone cancer, or bone sarcoma, is a cancerous tumor that starts in your bone. Experts aren't sure what causes it, but your genes may play a role. Some of the most common types of primary bone cancer are: Osteosarcoma often forms around your knee and upper arm.

How do I know if my knee pain is serious? ›

Make an appointment with your doctor if your knee pain was caused by a particularly forceful impact or if it's accompanied by:
  1. Significant swelling.
  2. Redness.
  3. Tenderness and warmth around the joint.
  4. Significant pain.
  5. Fever.

How do I get my knee to stop hurting? ›

Self-care measures for an injured knee include:
  1. Rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. ...
  2. Ice. Ice reduces both pain and inflammation. ...
  3. Heat. ...
  4. Compression. ...
  5. Elevation.
May 11, 2021

When should I be concerned about knee pain? ›

your knee is very painful. you cannot move your knee or put any weight on it. your knee is badly swollen or has changed shape. you have a very high temperature, feel hot and shivery, and have redness or heat around your knee – this can be a sign of infection.

What can cause knee pain without injury? ›

What Causes Knee Pain without Injury
  • Bursitis: Tiny sacs of fluid cushion the bones in the knee joint. ...
  • Tendinitis: Tendons are the tissue that binds muscle to bones, and tendinitis is common in the knee. ...
  • Baker's cyst: ...
  • Osteoarthritis: ...
  • Rheumatoid arthritis:

How can I be sure I don't have cancer? ›

What are some general signs and symptoms of cancer?
  1. Fatigue or extreme tiredness that doesn't get better with rest.
  2. Weight loss or gain of 10 pounds or more for no known reason.
  3. Eating problems such as not feeling hungry, trouble swallowing, belly pain, or nausea and vomiting.
  4. Swelling or lumps anywhere in the body.
Nov 6, 2020

Can knee cancer cured? ›

Today, about 3 out of 4 people who have osteosarcoma can be cured if the cancer hasn't spread to other parts of the body. Almost everyone who is treated with limb-sparing surgery ends up with that arm or leg working well. Many people who have osteosarcoma will need physical therapy for several months after surgery.

How long can you have lung cancer without knowing? ›

Scientists have discovered that lung cancers can lie dormant for over 20 years before suddenly turning into an aggressive form of the disease.

Does a chest xray show lung cancer? ›

A chest X-ray is usually the 1st test used to diagnose lung cancer. Most lung tumours appear on X-rays as a white-grey mass.

Which is worse right or left lung cancer? ›

Left side was associated with superior five‐year cancer‐specific survival (CSS) compared to right side NSCLC (HR 0.977, 95% CI 0.9574–0.9969; P = 0.024).

Can lung cancer be detected in a blood test? ›

Blood tests are not used to diagnose lung cancer, but they can help to get a sense of a person's overall health. For example, they can be used to help determine if a person is healthy enough to have surgery. A complete blood count (CBC) looks at whether your blood has normal numbers of different types of blood cells.

What happens to your body when you have lung cancer? ›

Both major types of lung cancer have similar symptoms, which often include a cough that doesn't go away and shortness of breath. However, lung cancer sometimes does not cause symptoms. Instead, it may be found during a chest X-ray performed for another condition, such as pneumonia.

Which cancers spread the fastest? ›

Examples of fast-growing cancers include:
  • acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML)
  • certain breast cancers, such as inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC)
  • large B-cell lymphoma.
  • lung cancer.
  • rare prostate cancers such as small-cell carcinomas or lymphomas.
Feb 13, 2019

How do you know death is near with lung cancer? ›

The dying person often sweats and, even though the skin is cool, it may feel wet and clammy. They usually stop eating and drinking, and this is normal. They will not feel thirsty or hungry. As death gets closer, the person's breathing may change.

Which lung cancer spreads the fastest? ›

Small Cell Lung Cancer

It is a fast-growing cancer that spreads much more quickly than other types of lung cancer. There are two different types of small cell lung cancer: Small cell carcinoma (oat cell cancer; most small cell lung cancers are of the oat cell type)

How do doctors test for lung cancer? ›

An X-ray image of your lungs may reveal an abnormal mass or nodule. A CT scan can reveal small lesions in your lungs that might not be detected on an X-ray. Sputum cytology. If you have a cough and are producing sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells.

Can you get cancer in your knees? ›

Fortunately, malignancy is a rare cause of knee pain; specifically, malignancies involving the patella are uncommon and are usually due to primary bone tumors such as osteosarcoma (1).

Can cancer cause arthritis symptoms? ›

Recent onset arthritis reminiscent of rheumatoid arthritis (RA) may be an early manifestation of an occult malignancy. In this report, we present two patients with cancer-associated polyarthritis.

Can knee pain be serious? ›

Not all knee pain is serious. But some knee injuries and medical conditions, such as osteoarthritis, can lead to increasing pain, joint damage and disability if left untreated. And having a knee injury — even a minor one — makes it more likely that you'll have similar injuries in the future.

Why do my knees ache at night? ›

Some of the most common sources for nighttime knee pain include runner's knee, osteoarthritis, bursitis, or injuries. Some of these conditions, like runner's knee, may resolve after you rest your knee. Others, like osteoarthritis, are chronic in nature.

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