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1.1 Signs and Symptoms of Lung Cancer

Forward to Section 1D Lung Cancer Screening Back to Section 1B Lung Cancer and Smoking.

You’ll never guess who I bumped into on the way to the opticians? Everyone!

1.1 Signs and Symptoms of Lung Cancer

 
Looking out for the early signs and symptoms of lung cancer is especially important as around 40% of diagnosed lung cancers are found after the disease has advanced.  It is estimated that lung cancer in around one third of all patients has reached Stage III on diagnosis.   Like all cancers, the earlier the disease is detected the better the prognosis and outcome.   The difficulty is that  patients with lung cancer may be asymptomatic until the tumor has grown large enough to obstruct airways or invade normal tissues.   Screening for individuals who fit the criteria (see Section 1d) could help detect lung cancer before it becomes symptomatic.

What’s the most breathless thing on Television? The Pink Panter Show!

Symptoms of  lung cancer vary according to where in the lungs the tumor is located.  Common signs and symptoms of lung cancer to look out for include the following:-

Cough

 
A persistent cough that does not go away is one of the most common symptoms of lung cancer.  Most people get a cough from time to time, but if it persists, produces a lot of mucus or has a deeper or hoarse sound then have it checked out. If you notice a friend or a family member persistently coughing advise them to see their family doctor. Do not dismiss a persistent cough as a ‘smoker’s cough‘.

Shortness of Breath:

 
There are  many medical reasons for shortness of breath (or dyspnoea) such as asthma, chronic obstructive airways disease (COPD),pulmonary  infections and heart problems. It can be a sign of lung cancer when a tumor begins to obstruct an airway or invade lung tissues. Shortness of breath can also occur as a result of fluid build-up (pleural effusion) around the lungs. If you or a family member become increasingly short of breath see a medical practitioner.

Hemoptysis (Coughing blood)

 
Coughing up blood or blood-stained sputum is never normal.  However, infection, causing inflammation and irritation of the airway, is the most common cause of hemoptysis.

The most common type of cancer associated with hemoptysis is squamous cell carcinoma.  However, it is importantly to know that in 7% of lung cancers hemoptysis is the only sign of cancer.  Cancer of the bronchus, or bronchogenic carcinoma, is a common lung cancer responsible for hemoptysis in 5 to 44 percent of all cases. Bleeding from malignant  tumors can be secondary to invasion of the lining of the bronchus, erosion into blood vessels, or highly vascular lesions.

Guidance from the National Institute for Clinical Excellence (NICE) has focused on the above three symptoms to try and raise public awareness of the early symptoms of lung cancer in the general population and also to alert general practitioners. Nice advise that if a patient has a new and persistent cough, develops breathlessness and has hemoptysis (blood in sputum) they should have a Chest X-Ray as soon as possible to rule out lung cancer.

Cough, shortness of breath and hoarseness are all really general symptoms though.

Yes, and the chances are that if you have any of these symptoms you probably won’t have lung cancer.

Yes,  but stick with the old motto,  ‘better safe than sorry.’

Hoarseness or Loss of Voice:

 
There are many causes for a hoarse voice or losing your voice. Firstly, these symptoms are usually due to inflammation caused by an infection or sometimes an allergy.  Hoarseness however, can be a sign of lung cancer as the tumor grows it can put pressure on the nerves that travel to the larynx (the voice box)  or on the larynx itself.  If there is no cause for the hoarseness of the voice such as a recent infection or ‘straining’ the voice, this is worrying.   Indeed, medical attention is necessary if there is any persistent hoarseness.

Chest Pain

 
Chest pain can sometimes be the first sign of lung cancer.  This is because of the tumor extending into the  lung lining or the ribs and muscle of the chest wall.  Chest pain associated with lung cancer is often described as persistent, aching and dull.   However, it is important to note that any incidence of chest pain needs to be investigated by a doctor.

Sometimes the only sign of lung cancer is upper back pain similar to a pulled muscle.  Always have any symptoms looked at.

Fatigue and weakness are two other symptoms that should send you straight to the doctors for a proper check-up.

Basically, go straight to your family physician with any persistent or worrying symptoms. Do not ignore any of the signs and symptoms of lung cancer listed above.

Signs and symptoms of lung cancer: Metastasis

 
Symptoms associated with metastatic lung cancer can include weight loss, abdominal pain due to involvement of the liver, adrenals and pancreas, and pain due to bone metastases.  Hypercalcemia is associated with squamous cell lung cancer.

Brain metastases are found in between 5% to 10% of patients with small cell lung cancer.  These patients may also have abnormal adrenocorticotropic hormone (ACTH) like activity, antidiuretic hormone (ADH) which leads to water retention with edema.

A ‘paraneoplastic syndrome’ may include sensory, motor, and autoimmune neuropathy. These symptoms may precede the detection of the primary tumor.

They say women appreciate persistence; a restraining order proved that was a lie.

References

 
Petty TL. (2001). The Early Diagnosis of Lung Cancer. Dis Mon. 47(6), 204–64. (Retrieved 22^nd Jan 2015): http://www.ncbi.nlm.nih.gov/pubmed/11473242

Spiro SG, Gould MK, Colice GL; American College of Chest Physicians. (2007) Initial evaluation of the patient with lung cancer: symptoms, signs, laboratory tests, and paraneoplastic syndromes: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007 Sep;132(3 Suppl):149S-160S. (Retrieved 30^th March 2015): http://www.ncbi.nlm.nih.gov/pubmed/17873166

More references for this section are on this page.

Patient Information

 
American Cancer Society Signs and Symptoms of Lung Cancer (Retrieved 14^th March 2015): http://www.cancer.org/cancer/lungcancer-non-smallcell/moreinformation/lungcancerpreventionandearlydetection/lung-cancer-prevention-and-early-detection-signs-and-symptoms

Center for Disease Control and Prevention (CDC) What Are the Symptoms of Lung Cancer? (Retrieved 30^th March 2015): http://www.cdc.gov/cancer/lung/basic_info/symptoms.htm

More patient information for this section is on this page..

Forward to Section 1D Lung Cancer Screening.Back to Section 1B Lung Cancer and Smoking.