Lung Cancer Symptoms

Lung cancer symptoms and presentation can vary but the most common types are due to the direct effects of the tumor on the lungs and thus breathing, as you might expect. Not unfrequently, patients can present with no symptoms and the tumor is identified incidentally (when an x-ray or CT scan is performed for another reason). Other symptoms can present due to distant spread of the cancer to other organs in the body or to more rare hormonal effects.

No Symptoms: As mentioned above, a small but significant group of patients will present incidentally without any noticeable lung cancer symptoms at all. The patient may receive a chest x-ray or CT scan for some other reason and a nodule or lump is discovered in the lungs, prompting a work-up which identifies it as cancer.

Cough: Cough is one of the common symptoms of lung cancer due to the direct irritation of the lungs by the growing tumor. A new cough in a smoker or prior smoker is concerning and should raise the possibility of lung cancer. A transient cough that is associated with a flu or cold but resolves spontaneously is less concerning than a new cough that does not resolve on its own or continues to get worse.

Coughing Up Blood: While coughing up blood in the sputum (called hemoptysis) is not always cancer, it is usually a significant cause for concern and should be worked up.

Chest Pain: Chest pain is not the most common symptom of lung cancer but there are many concerning diseases which can present with chest pain, including lung cancer (in about one fourth of patients), heart disease, pneumonia and pulmonary embolism. Therefore, like coughing up blood, it warrants work-up by a physician. The pain due to lung cancer is usually dull and persistent and is more common when there is invasion of other structures around the lungs by the tumor.

Shortness of Breath: Another of the most common lung cancer symptoms, shortness of breath, called dyspnea and wheezing can be due to direct irritation by the tumor, blockage of air flow and fluid collection around the outside of the lungs in the chest cavity (called pleural effusion). While there are other less ominous causes of shortness of breath and wheezing, new dyspnea can be concerning.

Frequent Respiratory Infections: Blockage of small airways in the lungs can lead to accumulation of bacteria and thus frequent, repeat respiratory infections such as bronchitis and/or pneumonia. While a single bout of these infections is not very concerning, repeat infections is much more concerning for an underlying problem in the lungs.

Metastases: Metastases are cancer that spread from the initial site of growth to distant organs or tissues in the body. Lung cancer can spread to many other organs, such as the liver, adrenal gland, bone and the brain. If a lung cancer spreads before the time of diagnosis a patient can present with symptoms of these metastatic tumors. The specific symptoms would vary depending on the exact site of the spread, the number of metastatic tumors and their size. For example, spread to the brain could result in seizures, weakness in a part of the body, loss of vision or other neurological dysfunction. Spread to bone can cause bone pain and fractures. Spread to the liver and adrenal glands are less likely to cause symptoms initially but can in rare advanced cases.

Paraneoplastic Syndromes: So-called paraneoplastic syndromes are widespread or distant symptoms which can be associated with some cancers. Small cell lung cancer, one of the sub-types of lung cancer, is commonly associated with these lung cancer symptoms, including swelling, fever, nail abnormalities (called clubbing of the nails) and even some hormonal effects such as inappropriate antidiuretic hormone secretion (which causes electrolyte abnormalities and urinary changes) or adrenocorticotropic hormone secretion (which causes weight gain, thinning of the skin, immune system dysfunction and other symptoms).