Quite a number of patients are very concerned when they develop back pain out of the blue.. The elderly particularly can be very worried. Not infrequently patients will know somebody who developed back pain and who was subsequently diagnosed as having cancer in their spine.

It is overwhelmingly true that most back pain is not associated with cancer.

However, sadly I do see one or two patients a year who have a cancer that is the cause of their back pain.

Mostly the cancer will have spread to the spine from another area. Sometimes the patient will be aware that they have or have had a cancer that may have potential to spread. On other occasions the back pain is the first symptom of a previously undiagnosed  cancer.

I never know for sure, just by talking to a patient, that they do or do not have cancer.

Often the first time I am aware is when a possible cancer shows up on an mri scan.

At that stage, especially if the patient is not known to have cancer, we have to conduct a search, using blood tests and more scans, to seek out the primary tumour.

I then have to ask a cancer specialist to see the patient and between a group of experts the correct treatment can be planned. Sometimes that involves surgery and more commonly other treatments, such as radio or chemotherapy.

Sometimes, but not always, there are some clues that a back pain may be caused by a serious illness. If pain is constant, not relieved by rest, bad at night, getting progressively worse, not helped by painkillers. Or if there are other symptoms such as weight loss, fevers, pains in other areas, we need to be very sure that the patient does not have a serious problem