What would be the first symptoms of cancer that has spread to the spine ?

Pain & neuro problem: This is an epidemiological question and is highly variable by individual. Pain is most ubiquitous. Pain can be from loss of structural integrity and/or collapse/fracture due to replacement of vertebral bone tissue with cancer tissue. Secondly, neurological compromise can be the first symptom - such as inability to move the limbs (below the level of involvement), feel the limbs, or limb pain.