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Signs and Symptoms of Lung Cancer

Updated: Jan 26, 2022

Lung cancer symptoms don't appear until the later stages when cancer starts to spread (metastasizes). In some instances, people may experience symptoms in the early stages of lung cancer. If you are experiencing any symptoms, see a doctor as soon as possible. Treatment is more likely to be effective if you catch it in the earlier stages.

Everyone is different and will experience different symptoms due to the location of the tumor and type of lung cancer. Symptoms can be related to the lungs or other parts of the body where cancer has spread or have general symptoms of not feeling well. Most people with lung cancer won't experience symptoms until the cancer is advanced. If you are at high risk of developing lung cancer, paying attention to the early warning signs is critical.

Early Warning Signs of Non-Small Cell Lung Cancer

Non-small cell lung cancer metastasizes slower than small cell lung cancer. Common warning signs include:

  • A new cough that is persistent or worsens, or a change in an existing chronic cough

  • Coughing up blood

  • Chest, back, or shoulder pain that worsens during coughing, laughing, or deep breathing

  • Bone pain

  • Shortness of breath

  • Feeling tired or weak

  • Lung infections such as bronchitis or pneumonia that don't go away

  • Hoarseness or wheezing

Early Warning Signs of Small Cell Lung Cancer

Small cell lung cancer progresses quickly, and symptoms typically appear when cancer has advanced to other organs.

Early signs can include:

  • A cough that is persistent or worsens

  • Coughing up blood or rust-colored phlegm

  • Pain in the chest, back, or shoulders that worsens during coughing, laughing, or deep breathing

  • Shortness of breath

  • Unexplained weight loss and loss of appetite

  • Feeling tired or weak

  • Bronchitis or pneumonia (or any other infections) that reoccur

  • Hoarseness or wheezing

Other Signs of Lung Cancer May Include:

  • Lumps or tumors (mass)

  • Difficulty swallowing

  • Changes or difficulty with bowel or bladder function

  • Unexplained bleeding or discharge

  • Swelling in the face or neck

  • Changes in the appearance of fingers, called finger clubbing

Lung Cancer Symptoms

When cancer spreads to other parts of the body, symptoms appear due to the local effects of the tumor.

Symptoms can include:

  • Cough is the most common symptom in 50% to 75% of cases. It is common in squamous cell and small cell lung cancers because of the origin of the tumor in the central airways.

  • Dyspnea commonly referred to as shortness of breath, is common in 25% to 40% of lung cancer cases. If the tumor spreads and blocks the major airways, it can cause pleural effusion (fluid to accumulate in the chest) around the lungs, leading to complications with breathing.

  • Bronchitis which causes hemoptysis (coughing up blood), occurs in 20% to 50% of lung cancer patients. Cancer can cause bleeding in the airway and lead to coughing up blood. People with a history of smoking are likely to experience this symptom. Treatments are available to regulate bleeding.

  • Metastasis, when lung cancer spreads to other parts of the body, such as the brain, liver, or bones, it can cause other symptoms to arise. Headaches, dizziness, nausea, pain, or jaundice are possible symptoms but, this depends on what organs are affected.

Symptoms of Advanced Lung Cancer

As cancer spreads, existing symptoms may worsen, and new symptoms may occur as other organs in the body become infected by cancer.

Symptoms may include:

  • Bone pain

  • Swelling of the face, arms, or neck

  • Headaches

  • Dizziness

  • Weakness or numbness

  • Jaundice

  • Lumps in the neck or collarbone area

Advanced Symptoms of Non-Small Cell Lung Cancer

  • Cancer spreading to the brain may cause headaches or seizures

  • A tumor pressing against a nerve can cause numbness or weakness in the arms or legs

  • Tumors spread to lymph nodes, and when they are close to the surface of the skin, they can cause lumps

  • Cancer can lead to possible nerve damage (Horner syndrome) or paraneoplastic syndromes (chemical reaction from cancer cells that trigger other reactions)

Advanced Symptoms of Small Cell Lung Cancer

  • Bone pain

  • Headaches

  • Dizziness

  • Weakness or numbness

  • Jaundice

  • Lumps in the neck or collarbone area

Lung Cancer Syndromes

Pancoast Syndrome

Pancoast syndrome is the result of superior pulmonary sulcus tumors or more commonly known as Pancoast tumors. Pancoast tumors have been seen in a small percentage of small cell lung cancers, 3% to 5%, but are more commonly associated with non-small cell lung cancers. They appear above the first rib in the apical pleuropulmonary groove. Pancoast tumors can spread to encompassing structures such as:

  • Brachial plexus: allows us to have movement from our shoulder to our hand. The brachial plexus is a network of nerves that sends signals from the spinal cord (at your neck) to your shoulders, arms, and hands. When the tumor has invaded the brachial plexus, it can cause weakness and numbness.

  • Cervical paravertebral sympathetic nervous system: are made up of ganglia (clusters of nerve cells) that send signals from the spine to points in the head and neck. If the cervical ganglia are damaged, Horner syndrome can develop.

  • Stellate ganglions: are a collection of nerves located on the front of the last vertebra of the neck. They are part of the sympathetic nervous system and control the face and arm.

Pancoast syndrome can cause pain in the shoulder that may extend to the inner arm, elbow, and fingers (pinky and ring fingers). Atrophy (shrink), paresis (partial paralysis), and paresthesia (prickly, tingling sensation) may occur over time, and Horners syndrome.

Horner Syndrome

Horner syndrome can develop from Pancoast tumors. If superior cervical ganglia are damaged, this can cause tension on the sympathetic trunk, leading to Horner syndrome to develop. Neck surgeries are an example of cause for damage to the cervical ganglia. The symptoms of Horner syndrome include miosis (constriction of the pupil), facial anhidrosis (abnormal sweating), and partial ptosis (drooping of the eye).

Paraneoplastic Syndrome

Symptoms associated with paraneoplastic syndrome have nothing to do with the tumor or metastasis. It is the result of the endocrine and immune mechanisms.

This occurs in roughly 10% to 20% of lung cancer patients. The endocrine (hormone system), neurologic (communication system), dermatologic (protection system), and hematologic (blood and tissue) systems are most commonly affected. Paraneoplastic syndrome has been linked to non-small cell lung cancer but is more closely associated with small-cell lung cancer cases.

When to See a Doctor

If you are experiencing any symptoms and are at high risk of developing lung cancer, you should talk to your doctor about having a routine screening. A doctor will conduct a thorough checkup and might order x-rays or other tests. Screenings for high-risk people developing lung cancer offer hope for early detection and treatment.

People considered at high risk for developing lung cancer:

  • Have a history of heavy smoking (smoking at least one pack a day for 30 years).

  • Current or former smokers who quit within the past 15 years.

  • Between the ages of 55 and 80.

If your doctor detects anything abnormal during a lung cancer screening, diagnostic tests such as imaging scans and biopsies (lung tissue sampling) are the next step.

Lung Cancer Diagnosis

If the screening tests suggest a person has lung cancer, a pathologist may order some tests. The pathologist will examine the patient's lung cells in sputum, phlegm, or from a biopsy sample to type and stage the lung cancer.

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