What Are the Symptoms of Bone Cancer in Hips?

Hip pain is common and is most likely caused by injury, overuse, or a chronic condition like arthritis. Signs of bone cancer often overlap with the symptoms of these conditions. However, bone cancer in the hip is a rare occurrence.

In fact, primary bone cancer, or cancer that begins in the bone, accounts for less than 1% of all new cancers. Bone cancer in the hip can cause pain, limping, fractures of the bone, and hypercalcemia, a condition in which there is too much calcium in the blood. 

If you're worried about pain in your hip and wonder what bone cancer feels like, you may be relieved to know that most pain in the hip is not caused by cancer. Since many symptoms of bone cancer in the hip are often caused by other conditions, it's important that your healthcare provider conduct a careful and thorough examination of your hip.

This article explains the four primary types of bone cancer and how bone pain is the main symptom of bone cancer. Swelling, fatigue, fever, and limping are other symptoms of bone cancer.

Types of Hip Bone Cancer

Bone cancer falls into one of two categories: primary and metastatic. Primary bone cancer begins in the bones whereas metastatic bone cancer spreads from other parts of the body. Metastatic cancer is due to metastases from other cancers, most commonly breast and prostate.

These are four main types of primary bone cancer that can affect the hip:

Osteosarcoma

Osteosarcoma typically occurs in children, adolescents, and young adults. It most often affects the arm near the shoulder and the leg near the knee. But it can also occur in any bone, especially in adults. Osteosarcoma tumors can grow quickly and spread to other parts of the body, including the lungs.

Chondrosarcoma

Chondrosarcoma starts in the cartilage, which is connective tissue that covers the ends of bones and holds the joints together. This type of cancer mainly affects adults who are at least 40 years old. It becomes more common as people age.

In adults, this is the type of bone cancer most likely to affect the hip. Chondrosarcoma usually forms in the pelvis, upper leg, and shoulder. It grows slowly.

Ewing Sarcoma

Ewing sarcoma is a highly malignant tumor that affects the bones and soft tissue of children and adolescents. It most commonly affects the iliac bone, which is the largest bone of the hip. Children and teens often present with pain, limping, and a fever that comes and goes.

Chordoma

Chordoma is an extremely rare tumor that forms in the spine—most often at the base of the spine or base of the skull. These tumors typically occur in older adults. Twice as many men as women are affected.

When the tumor is at the base of the spine, it can cause pain down the legs and affect the ability to control the bladder and bowels.

Pain

Twenty percent of bone cancer patients experience no symptoms of their condition. For everyone else, bone pain is often the first symptom to appear. Sometimes this pain can occur before tumors can be seen on X-rays or computed tomography (CT) and magnetic resonance imaging (MRI) scans.

Usually, the pain begins spontaneously and varies in severity, depending on the stage of the disease. However, the intensity of the pain does not always correlate to the type and location of the tumor. Often, the bone pain gets worse with movement and can be accompanied by a fever. Typically, the pain increases at night. At the beginning of the disease, most people experience dull aches that come and go. As time passes, the pain may become more severe and constant.

If the tumor continues to grow, breakthrough pain may occur. Breakthrough pain is pain that comes on suddenly. It can be very severe but often does not last for long periods of time. In half of all bone cancer patients, this pain often lasts less than 15 minutes.

While bone pain is the main symptom of bone cancer, and pain in the hip bone can be an indication of a tumor in the hip, there are often other explanations for hip pain. Correctly diagnosing hip pain can be difficult because the hip joint is complex and deeply buried in the body. These factors make it difficult for healthcare providers to pinpoint the correct cause of the pain. Some common causes of hip pain are:

• Femoroacetabular (FAI) syndrome, an impingement of the hip
• Fracture
• Hip bursitis, an inflammation of the hip joint
• Hip dysplasia, a problem with the development of the hip joint
• Injury
• Osteoarthritis
• Overuse
• Rheumatoid arthritis
• Spine problems that radiate to or affect the hip
• Spondyloarthritis, an umbrella term for several types of inflammatory diseases
• Tendonitis
  

Swelling

Swelling is another symptom of bone cancer. It often occurs after pain has progressed and can occur at the site of the tumor. Sometimes, it's possible to feel a mass, which would indicate a tumor.

In children and teens, swelling and pain are very common and much more likely to be caused by normal bumps and bruises from playing or participating in sports. In adults, swelling is less common unless there is a direct injury.

Even though swelling can occur with bone cancer in the hip, swelling is often a sign of something else. Swelling in the hip can be caused by an injury or a condition like bursitis, which is inflammation of the fluid-filled sacs around the joint.

Fatigue and Fever

If you have bone cancer in the hip, you may experience cancer-related fatigue. Between 80% and 100% of people with cancer feel this extreme tiredness or lack of energy. It can make completing daily tasks like brushing your teeth feel as exhausting as running a marathon. While rest is important with any disease, adequate rest doesn’t always provide relief from bone pain.

The reasons for fatigue caused by cancer aren’t fully known. However, researchers suspect it is triggered by a change in hormone or protein levels that are linked to inflammation or caused by toxins produced by the cancer itself. Some cancer treatments also cause fatigue.

Having a fever without an explanation can also indicate bone cancer in the hip. Malignant tumors are known to cause fever. If you are not sick and have no other explanation for a fever, this may be the case. In people who have a diagnosed cancer, a fever usually indicates infection, which should be treated right away.

Limping

As with other signs of bone cancer, limping can indicate a tumor in the hip. However, limping can also be the result of injury to the site, such as a fracture. Rheumatic disease, arthritis, or other conditions that affect the tendons surrounding the hip and the hip joint can also cause limping.

While a limp does not necessarily mean you have bone cancer in the hip, a limp that does not go away should be fully evaluated by a healthcare provider. If limping is caused by bone cancer in the hip, it is usually a symptom of later-stage bone cancer. This is often brought on by a broken bone or fracture caused by the tumor.

Treatment Options

To properly diagnose bone cancer, a healthcare provider takes a full health history, conducts a physical exam, orders X-rays, and possibly uses imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) scans.

A biopsy of the tumor may also be taken. However, while a biopsy is very accurate in diagnosing malignant tumors, it will not indicate how far the cancer has progressed.

Tumors that grow in bones can be malignant (cancerous) or benign (non-cancerous). Benign bone tumors are much more common. Both types of tumors can grow and affect healthy bone tissue, though benign ones often do not spread or destroy bone tissue.

Summary

Feeling pain in your hip doesn't mean you have bone cancer in your hip. In fact, the chance of this happening is rare indeed. Still, there are two categories of bone cancer: primary and metastatic. Primary bone cancer begins in the bones whereas metastatic bone cancer spreads from other parts of the body. Bone cancer can be further broken down among osteosarcoma, chondrosarcoma, Ewing sarcoma, and chordoma. Swelling, limping, fatigue, and fever are signs of bone cancer.

A Word From Verywell

The likelihood of hip pain being cancerous is very low, but don't use it as an excuse not to talk with your healthcare provider. This is especially if the pain persists or begins to affect the way you walk or go about your daily life. Many tumors in the bone do not show symptoms until they have progressed and affected the surrounding area. Physicians don't call tumors "sneaky" for nothing.