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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.

General symptoms

There may be no symptoms at the onset of the disease. When present, common symptoms of lung cancer may include:

Coughing: This includes a persistent cough that doesn’t go away, or a cough that changes to a chronic “smoker’s cough,” with more coughing or pain.

Coughing up blood: Coughing up blood or rust-colored sputum (spit or phlegm) should always be discussed with your doctor.

Breathing difficulties: Shortness of breath, wheezing or noisy breathing (called stridor) may all be signs of lung cancer.

Loss of appetite: Many cancers cause changes in appetite, which may lead to unintended weight loss.

Fatigue: It is common to feel weak or excessively tired.

Recurring infections: Recurring infections, like bronchitis or pneumonia, may be one of the signs of lung cancer.

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.