Lung cancer

Lung cancer symptoms

The early symptoms of lung cancer may be a slight cough or shortness of breath, depending on which part of the lung is affected. 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, like loss of appetite or general fatigue.

Early warning 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 but commonly 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 symptoms of lung cancer may include:

• 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 NSCLC 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, symptoms of SCLC continue to evolve and worsen as the disease spreads to distant organs.

Early symptoms of SCLC:

• 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.

Get expert advice and care

Understanding when symptoms are a sign of something serious and either diagnosing the disease or confirming a previous diagnosis require expertise from specialists trained and experienced in treating lung cancer. At Cancer Treatment Centers of America^® (CTCA), our lung cancer experts treat all stages of the disease.