Lung cancer symptoms

Early symptoms of lung cancer may include a worsening cough or shortness of breath, depending on which part of the lung is affected and which type of lung cancer the patient has. As the cancer develops, these symptoms may become more severe or intense.

Like many other types of cancer, lung cancer may also cause systemic symptoms, which are more general in nature. These may include loss of appetite or general fatigue.

To help answer common questions on lung cancer signs and symptoms to look for, this guide will cover:

• A visual guide to signs and symptoms of lung cancer
• Early signs of lung cancer
• Advanced lung cancer symptoms
• Non-small cell lung cancer symptoms
• Small cell lung cancer symptoms
• Metastatic lung cancer symptoms
• Lung cancer in women and men
• Types of lung cancer in men and women
• Symptoms of lung cancer in men and women
• The Lung Cancer Centers at City of Hope

If you believe you may be experiencing symptoms of lung cancer and want to schedule an appointment for diagnostic testing, or if you’re interested in a second opinion for lung cancer at City of Hope, call us or chat online with a member of our team.

Early signs of lung cancer

Most lung cancers don't cause symptoms until the disease has advanced, in part because the lungs have few nerve endings. When lung cancer does cause signs in its early stages, they may vary from person to person. However, lung cancer symptoms may include:

• A new cough that is persistent or worsens, or a change in an existing chronic cough
• Cough that produces blood
• Pain in the chest, back or shoulders that worsens during coughing, laughing or deep breathing
• Shortness of breath that comes on suddenly and occurs during everyday activities
• Unexplained weight loss
• Feeling that you are tired or weak
• Loss of appetite
• Lung infections such as bronchitis or pneumonia that won't go away
• Hoarseness or wheezing

Less common lung cancer symptoms

• Swelling in the face or neck
• Difficulty swallowing or pain while swallowing
• Changes in the appearance of fingers, called finger clubbing

Although most of these symptoms are more likely to be caused by something other than lung cancer, it's important to see a doctor. Discovering lung cancer early may mean more treatment options are available.

Advanced lung cancer symptoms

Advanced stages of lung cancer are often characterized by the spread of the cancer to distant sites in the body. This may affect the bones, liver or brain. As other parts of the body are affected, new lung cancer symptoms may develop, including:

• Bone pain
• Swelling of the face, arms or neck
• Headaches, dizziness or limbs that become weak or numb
• Jaundice
• Lumps in the neck or collarbone region

Non-small cell lung cancer symptoms

Non-small cell lung cancers (NSCLC) may grow slowly over a period of time before symptoms develop. Common non-small cell lung cancer symptoms include:

• Persistent coughing, particularly without any known cause
• A cough that produces blood or red-colored phlegm (hemoptysis)
• Chest pain or painful breathing
• Difficulty breathing or shortness of breath
• Fatigue or feeling unusually weak or tired
• Hoarseness or wheezing
• Frequent upper-respiratory infections, like bronchitis or pneumonia
• Bone pain

Other areas of the body may be affected by either the spread or development of NSCLC tumors.

Neurological changes: Lung cancer may spread (metastasize) to the brain. This may cause headaches or even seizures. Numbness or weakness in the arms and legs may occur if a large tumor begins to press against a nerve.

Lumps: In advanced stages, the cancer may spread throughout the lymph nodes. Sometimes, tumors near the skin surface may appear as lumps.

Horner syndrome: Tumors may possibly cause nerve damage. Horner syndrome is a particular set of symptoms associated with nerve damage. The symptoms often affect one side of the face, causing a droopy eyelid and a reduction in the size of the pupil (the dark center of the eye).

Paraneoplastic syndromes: Cancer cells may make chemicals that trigger other reactions, which are collectively referred to as paraneoplastic syndromes. Symptoms may include high blood calcium levels (hypercalcemia), excess bone growth or blood clots.

Small cell lung cancer symptoms

Most of the signs associated with small cell lung cancer (SCLC) are not present until the cancer has progressed. Typically, small cell lung cancer symptoms continue to evolve and worsen as the disease spreads to distant organs.

Early symptoms of small cell lung cancer:

• Persistent cough
• Chest pain that gets worse with deep breathing, laughing or coughing
• Hoarseness
• Unexplained loss of appetite and weight
• Coughing up blood or rust-colored phlegm
• Shortness of breath
• Feeling weak and/or tired
• Bronchitis, pneumonia or other infections that keep recurring
• Wheezing

Symptoms of advanced-stage SCLC:

• Bone pain
• Headaches, dizziness or limbs that become weak or numb
• Jaundice
• Lumps in the neck or collarbone region

Paraneoplastic syndromes and lung cancer

Sometimes, SCLC can cause paraneoplastic syndromes. While not always the case, these syndromes are often early signs of SCLC.

SCLC may cause one of these three paraneoplastic syndromes: Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH), Cushing syndrome or Lambert-Eaton syndrome. Symptoms of paraneoplastic syndromes include muscle cramps, muscle weakness, elevation of calcium in the blood and clubbing, which refers to a change in the shape of the finger tips.

Metastatic lung cancer symptoms

Metastatic lung cancer symptoms depend on the part of the body to which the cancer has spread, as well as the size and location. Sometimes, metastatic disease may not cause any symptoms, though about 30 percent to 40 percent of people with lung cancer will have symptoms of metastasis.

• If the cancer has spread to the bones, it may cause bone pain, often in the vertebrae or ribs. Other symptoms include fractures, constipation or decreased alertness due to high calcium levels.
• If the liver is affected, symptoms may include nausea, extreme fatigue, increased abdominal girth, swelling of the feet and hands due to fluid collection, and yellowing or itchy skin.
• If either the brain or spinal cord is affected, symptoms may include headache, blurred or double vision, difficulty with speech or seizures.

Lung cancer in women and men

Lung cancer is the second most common type of cancer diagnosed in both men and women (excepting skin cancer), according to the American Cancer Society (ACS). Only prostate cancer is more common for men, and breast cancer is more common for women.

However, lung cancer is the No. 1 cause of cancer death for both genders by far compared with other cancers. Below is a look at the statistics.

• An estimated 117,550 men and 120,790 women are expected to be diagnosed with lung cancer in 2023, according to the ACS, with an estimated 67,160 deaths among men and 59,910 among women.
• The number of patients diagnosed with lung cancer has decreased steadily throughout the past several years, according to the ACS, largely due to a decline in smoking habits.
• Women tend to be diagnosed at an earlier age than men.
• Women who develop lung cancer before menopause are more likely to be diagnosed with advanced disease. (They also are likely to have more spread and a poorer prognosis.)

Types of lung cancer in women and men

The types of lung cancer differ among women and men as well:

• Women tend to develop NSCLC more than men.
• Women are more likely to be diagnosed with lung adenocarcinoma than men (adenocarcinoma is a type of NSCLC that isn’t necessarily associated with smoking).
• Female nonsmokers are more likely than male nonsmokers to be diagnosed with the lung cancer subtype bronchioalveolar carcinoma.
• Women who have lung cancer are more likely to live longer than men.
• Women who undergo surgery for some lung cancers, including NSCLC, also live longer than men. Women have a better response to chemotherapy treatments for lung cancer than men do.
• Men are more likely to be diagnosed with squamous cell carcinoma than women.

Symptoms of lung cancer in women and men

Generally speaking, the signs and symptoms for lung cancer are similar for men and women and may vary depending on where in the body the cancer forms. 

For example, squamous cell carcinoma forms on the lining of the lungs. Signs of this type of cancer include:

• Chest pain
• Recurrent or worsening cough
• Difficulty breathing
• Bloody cough
• Hoarseness
• Loss of appetite
• Unintended weight loss
• Fatigue
• Difficulty swallowing
• Swelling in the face and neck veins

In addition to the symptoms above, adenocarcinoma, which typically forms in the outer areas of the lung, may also cause back pain, especially in women.

The Lung Cancer Centers at City of Hope

Because lung cancer is often diagnosed after it’s progressed to an advanced stage, it’s important to turn to a clinical team with expertise to tailor a treatment plan specific to your tumor type, stage, genomic markers and other needs. Having a team of lung cancer experts collaborating daily, all under one roof, allows us to assemble a detailed treatment plan more quickly and more efficiently.

At the Lung Cancer Centers at each of our hospitals, our cancer experts are devoted to a single mission—treating lung cancer patients with compassion and precision. This singular focus enables our oncologists to stay up to date on new and emerging treatments and technologies, allowing us to help you make informed decisions about the options available to treat not just the disease but the side effects that may result. Clinical trials in immunotherapy, cryotherapy and other areas of innovation may be among the options available.

Each patient’s care team is led by a medical oncologist and coordinated by a nurse, who helps keep track of the various appointments, follows up on tests and answers questions that come up along the way. Your care team also may include a surgeon, radiation oncologist, radiologist, pathologist and interventional pulmonologist with specialized training in non-invasive procedures to help preserve lung function and reduce side effects.

As part of our patient-centered care model, which is designed to help you keep strong during treatment, your multidisciplinary care team may recommend various evidence-informed supportive therapies, such as naturopathic support, psychosocial support, nutritional support, physical and rehabilitation therapy and pain management. The entire team works together with a whole-person focus, which is at the heart of the centers’ dedication to personalized, comprehensive care.

If you believe you may be experiencing symptoms of lung cancer and want to schedule an appointment for diagnostic testing, or if you’re interested in a second opinion for lung cancer at City of Hope, call us or chat online with a member of our team.