People can experience shoulder blade pain due to a variety of issues such as arthritis, muscle or nerve injury, or rotator cuff injury. However, in some cases, shoulder blade pain can also occur in patients with lung cancer.

Referred Pain

Can Shoulder Pain Be Referred Pain?

Shoulder pain may be due to many causes not related to cancer. However, “one of the most common causes of shoulder pain in patients with lung cancer is referred pain. This is when the body experiences pain from an internal organ, such as the lung, but it is felt in a different part of the body, such as the shoulder,” said Julia Rotow, MD, a thoracic oncologist at the Dana Farber Cancer Institute in Boston.

Shoulder pain does not happen in every patient with lung cancer, noted Dr. Rotow, but when any new pain occurs, it is important to let your oncology team know. In that case, they may recommend imaging such as a CT scan or MRI to determine the exact source of the pain.

Associated Cancers

What Cancers Are Associated With Shoulder Pain?

Dr. Rotow noted that there are different types of cancer that can be associated with shoulder pain. These include:

Pancoast tumors

“These are also known as superior sulcus tumors and can be associated with shoulder pain due to their location at the very top of the lung which is right below the shoulder,” Dr. Rotow said. These can also cause pain, numbness, or loss of strength in the arm.

Mesothelioma

This is a different kind of cancer in the chest that involves the lining of the lungs. “In this case, ,you may experience pain in the chest that refers up to the shoulder,” Dr. Rotow said.

Metastatic cancer

While Dr. Rotow noted that shoulder pain does not always indicate metastatic or more advanced disease, it does raise concern for a complication in a patient that has a pre-existing cancer diagnosis. Spread of lung cancer to the lining of the lungs or to bone, may cause pain and need to be investigated further.

Cancer Treatment

Will My Cancer Treatment Help My Shoulder Pain?

“The good news is that, if you are undergoing treatment for lung cancer, and the treatment is effective, the shoulder pain will often improve as well,” Dr. Rotow said.

“Even in the absence of a known cancer diagnosis, I want to emphasize that there are many causes of shoulder pain. Lung cancer is not the most common cause,” she said. There are many benign causes of pain that your doctor will likely look for first because they are so much more common. However, as always, it is best to speak to your doctor and not ignore any new symptoms.

This article was originally published September 20, 2023 and most recently updated October 10, 2023.
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Jennifer Garcia, Medical Writer:  
Natalie Vokes, MD, Assistant Professor, Department of Thoracic/Head and Neck Medical Oncology: