Health Tips

Symptoms of lung cancer are varied dependent upon where and how widespread the tumor is. Warning signs of lung cancer are not always present or easy to identify. A person with lung cancer may have the following kinds of symptoms:

• No symptoms: In up to 25% of people who get lung cancer, the cancer is first discovered on a routine chest x-ray or CT scan as a solitary small mass sometimes called a coin lesion. These patients with small single masses often report no symptoms of lung cancer at the time it is discovered.
  
  
• Symptoms related to the cancer: The growth of the cancer and invasion of lung tissues and surroundings may interfere with breathing, leading to symptoms such as cough, shortness of breath, wheezing, chest pain, and coughing up blood (hemoptysis). If the cancer has invaded nerves, for example, it may cause shoulder pain that travels down the outside of the arm (called Pancoast's Syndrome) or paralysis of the vocal cords leading to hoarseness. Invasion of the esophagus may lead to difficulty swallowing (dysphagia). If a large airway is obstructed, collapse of a portion of the lung may occur and cause infections (abscesses, pneumonia) in the obstructed area.
  
  
• Symptoms related to metastasis: Lung cancer that has spread to the bones may produce excruciating pain at the sites of bone involvement. Cancer that has spread to the brain may cause a number of neurologic symptoms that may include blurred vision, headaches, seizures, or symptoms of stroke such as weakness or loss of sensation in parts of the body.
  
  
• Paraneoplastic symptoms: Lung cancers frequently are accompanied by so-called paraneoplastic syndromes that result from production of hormone-like substances by the tumor cells. Paraneoplastic syndromes occur most commonly with SCLC but may be seen with any tumor type. A common paraneoplastic syndrome associated with SCLC is the production of a hormone called adrenocorticotrophic hormone (ACTH) by the cancer cells, leading to oversecretion of the hormone cortisol by the adrenal glands (Cushing's syndrome). The most frequent paraneoplastic syndrome seen with NSCLC is the production of a substance similar to parathyroid hormone, resulting in elevated levels of calcium in the bloodstream.
  
  
• Nonspecific symptoms: Nonspecific symptoms seen with many cancers including lung cancers include weight loss, weakness, and fatigue. Psychological symptoms such as depression and mood changes are also common.

When should one consult a doctor?

One should consult a health care provider if they develop the symptoms associated with lung cancer, in particular, if they have

• a new persistent cough or worsening of an existing chronic cough,
  
  
• blood in the sputum,
  
  
• persistent bronchitis or repeated respiratory infections,
  
  
• chest pain,
  
  
• unexplained weight loss and/or fatigue, and/or
  
  
• breathing difficulties such as shortness of breath or wheezing