Symptoms of lung cancer
Hypertrophic pulmonary osteoarthropathy is a condition that affects some people with lung cancer. It most often causes inflammation of bones and joints in the wrists and ankles. Another common symptom is clubbing of the fingers.
HPOA is a group of symptoms that can affect the bones and joints. It is a rare syndrome. It is also called Bamberger–Marie syndrome.
In cancer, HPOA can be caused by substances released by the tumour. Or it could be caused by substances the body makes when reacting to the tumour.
People with lung conditions can get HPOA. In cancer it is most common in people with non small cell lung cancer. It also affects people with pleural mesothelioma.
We don't know why some people with lung cancer get it and others don't.
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 pain and difficulty with movement.
One of the most common symptoms of HPOA is a condition known as clubbing. This means:
the nails seem to ‘float’ instead of being firmly attached to the nailbed
the nails form a sharper angle with the cuticle
the last part of the finger may appear large or bulging and may be warm and red
the nail curves downward, so it looks like the round part of an upside down spoon
Clubbing of the fingers is a common symptom of lung and heart conditions. It is thought that it is caused by vascular endothelial growth factor (VEGF). VEGF is a type of growth factor. Growth factors are chemicals produced by the body that control cell growth. The lack of oxygen in the blood makes the body produce VEGF.
Treatments for lung cancer can help to reduce the symptoms of HPOA.
Painkillers, such as non steroidal anti inflammatory drugs, can reduce inflammation and help to reduce swelling and pain.
Bisphosphonates can help to relieve pain in people with HPOA whose lung cancer doesn’t respond to treatment. Bisphosphonates help to slow the breakdown of bone.
The symptoms of HPOA can make you uncomfortable and can be very hard to cope with. Your doctors will do all they can to make sure you are as comfortable as possible.
Your doctor or specialist nurse can give you information about your condition.
Last reviewed: 07 Oct 2025
Next review due: 06 Oct 2028
Lung cancer starts in the windpipe (trachea), the main airway (bronchus) or the lung tissue. Cancer that starts in the lung is called primary lung cancer.
Your treatment depends on several factors. These include what type of lung cancer you have, how big it is and whether it has spread (the stage). It also depends on your general health.
Metastatic lung cancer means that the cancer has spread from where it started in the lung to other parts of the body. It is also called advanced lung cancer.
Lung cancer doesn't always cause symptoms in its early stages. Symptoms can include a cough that won't go away, coughing up blood and breathlessness.
Mesothelioma is a cancer that most commonly starts in the sheets of skin-like tissue that cover each lung (the pleura). More rarely it starts in the sheet of tissue in the abdomen that covers the digestive system organs (the peritoneum).
Lung cancer starts in the windpipe (trachea), the main airway (bronchus) or the lung tissue. Cancer that starts in the lung is called primary lung cancer.
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