Lung cancer may not cause noticeable symptoms in its early stages, and there are not yet good lung-cancer screening tests for people who aren’t high-risk. Although early signs and symptoms of lung cancer are uncommon — due in part to the lungs’ lack of nerve endings — some early indicators may include milder versions of the common symptoms of later-stage lung cancer.

Signs and symptoms differ in that symptoms are what a person experiences, like pain or nausea; signs are what a doctor can observe and measure, such as a fever or high blood pressure. If you are concerned about any symptoms you might have, be sure to set up an appointment and talk to your health care provider who can provide guidance about your particular situation.

Early Lung-Related Signs and Symptoms

Some early indicators of lung cancer may come from a tumor compressing major structures in the lungs, such as the bronchi (airways) or trachea (windpipe). This compression can lead to:

• Shortness of breath
• A new or worsening chronic cough that may involve coughing up blood or blood-tinged phlegm
• Hoarseness of voice

As lung tumors grow, they drain energy from healthy cells around the body, leading to gradual weight loss and loss of appetite. The cancer also saps the body’s natural ability to fight off infections, which can lead to lung infections such as pneumonia and bronchitis that won’t go away.

Early Signs and Symptoms Around the Body

Some symptoms can develop from the lung tumor pressing on structures around the lung, such as nerves and blood vessels.

Shoulder and Arm Pain

Shoulder and arm pain are symptoms typically associated with a class of lung cancers called Pancoast’s tumors, which develop at the top tip of the lung. Pancoast’s tumors and some other lung tumors can press on the major nerves that carry signals from the spinal cord to muscles in the shoulders and arms, causing them to hurt.

Horner’s Syndrome

Horner’s syndrome is another possible early indicator of Pancoast's tumors and other lung tumors that compress what are called sympathetic nerves. Sympathetic nerves are responsible for our natural response to fear and danger, such as wide eyes, wide pupils, and sweating. People with Horner's syndrome from lung cancer can have:

• Droopy eyelids
• Narrow pupils
• Flushing
• Lack of sweat

Symptoms of Horner's syndrome often affect just one side of the face, usually the side the lung tumor is on.

Swelling in the Face and Upper Body

Superior vena cava (SVC) syndrome may cause swelling in the face and upper body. The SVC is a large vein that drains blood from the head and upper body. When tumors compress the SVC, the blood backs up and causes swelling and redness in the face and upper body.

Paraneoplastic Syndromes and Systemic Signs and Symptoms

Certain lung tumors called paraneoplastic syndromes can produce cancer-related effects on the body as a whole. Paraneoplastic syndromes are caused by hormones or other proteins that are released from a tumor into the bloodstream.

Blood Clots

Lung cancer can cause the body to enter what is called a hypercoagulable state, which makes you much more susceptible to blood clots.

High Calcium Levels

A type of lung cancer called squamous cell carcinoma produces a hormone similar to the body’s own hormone for regulating calcium levels. Overproduction of the cancer-related hormone can cause too much calcium to build up in the blood, a condition called hypercalcemia. This may cause:

• Nausea and vomiting
• Increased urination
• Abdominal pain
• Confusion, headaches, and trouble thinking

Low Sodium Levels

Certain lung tumors produce excess amounts of a hormone called antidiuretic hormone (ADH), which normally causes the body to retain water instead of making urine. ADH also dilutes the blood to prevent sodium and other electrolyte levels from getting too high. When a tumor produces too much ADH, it can cause sodium levels to dip too low. This sign is called syndrome of inappropriate ADH (SIADH). SIADH is more common in small cell lung cancers (SCLCs) than non-small cell lung cancers (or NSCLCs).

Low sodium levels can cause nausea or vomiting in mild cases, and cognitive impairment, confusion, hallucinations, and seizures in more severe cases.

Cushing’s Syndrome

Cushing’s syndrome — often associated with SCLC — develops when lung cancer produces a hormone called adrenocorticotropic hormone, which then causes cortisol to be released. Cortisol is the hormone responsible for our normal response to stress. Too much cortisol in the body can lead to signs and symptoms such as:

• Increased fat deposits around the body
• Stretch marks
• Muscle weakness
• Bone loss and fractures
• High blood pressure
• High blood sugar

Talk With Others Who Understand

MyLungCancerTeam is the social network for people with lung cancer and their loved ones. Thousands of members come together to ask questions, give advice, and share their stories with others who understand life with lung cancer.

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