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Early Symptoms of Lung Cancer in Nonsmokers

Medically reviewed by Mark Levin, M.D.
Written by Emily Wagner, M.S.
Posted on July 13, 2021

Lung cancer is the most common type of cancer in the world, but there are currently no good screening tests for it. Lung cancer screening is expensive and only recommended for people who currently smoke or have smoked in the past. Although smoking is certainly a risk factor for developing lung cancer, it is also possible for someone who has never smoked to develop lung cancer. Therefore, it is important to be aware of the early symptoms of lung cancer so that you can have a conversation with your doctor about any concerns.

Early Symptoms of Lung Cancer

The lungs have very few nerve endings, meaning that symptoms are harder to notice in the earlier stages. Most symptoms aren’t noticed until cancer has progressed to later stages, which is why most cases of lung cancer are diagnosed later.

In the early stages of lung cancer, you may notice milder versions of some common symptoms. These symptoms can happen when a tumor presses on structures in the lungs, such as the airways (bronchi), which can lead to:

  • Shortness of breath
  • A persistent cough that continues to get worse
  • Chest pain
  • Coughing up blood or phlegm
  • Hoarseness from a tumor pressing on the main airway (trachea)
  • Repeated episodes of pneumonia, or pneumonia that doesn’t go away with treatment

As the tumor continues to grow, it takes energy and resources away from the healthy cells in the body. This can make you feel tired, weak, and generally unwell.

The immune system is also trying to fight off cancer, and in the process, immune cells release proteins called cytokines. These proteins can lead to loss of appetite, weight loss, and muscle loss. This effect also makes it harder for the body to fight infections, so you may have chronic bronchitis or pneumonia that doesn’t go away.

Whole-Body Syndromes

In some cases of lung cancer, syndromes with specific sets of symptoms can develop. These syndromes tend to affect the entire body, not just the lungs.

These syndromes happen when tumors press against larger structures in the chest, or if cancer releases hormones into the body (paraneoplastic syndromes). They can also happen if there is an abnormal immune response to cancer.

Superior Vena Cava Syndrome

The superior vena cava (SVC) is a large vein that is responsible for returning blood flow from the chest, head, neck, and arms to the heart. If a tumor presses on the SVC, it can restrict the blood flow and cause swelling in the face, neck, chest, and arms in what’s known as SVC syndrome. Other symptoms of SVC syndrome include:

  • Headaches
  • Dizziness
  • Bluish-red coloring in the skin

Horner Syndrome

Horner syndrome results in a decreased pupil size, a drooping eyelid, and decreased sweating on the affected side of your face. Pancoast tumors are more common in cases of non-small cell lung cancer (NSCLC) than small cell lung cancer (SCLC). Pancoast tumors cause a specific set of symptoms, including:

  • Pain in the shoulder, shoulder blade, neck, ribs, and arms
  • Upper arm swelling
  • Numbing or tingling in the hands
  • Sweating on only one side of the face (typically the side where the tumor is located)

Paraneoplastic Syndromes

Paraneoplastic syndromes are caused by hormones or other proteins that are released from a tumor. These can happen in any type of cancer, but they are most common in lung cancer. Paraneoplastic syndromes occur in roughly 10 percent of people with lung cancer.

The symptoms of paraneoplastic syndromes may be noticed before any lung cancer symptoms appear. If you develop symptoms of paraneoplastic syndromes, your doctor may order tests and discover lung cancer in an early and treatable stage.

Symptoms of these syndromes include:

  • Slurred speech
  • Knee or bone pain
  • Vision problems
  • Difficulty walking
  • Difficulty swallowing
  • Dizziness or vertigo
  • Seizures
  • Loss of feeling in the arms and legs

Nonsmoking Causes of Lung Cancer

If you think you have lung cancer symptoms, it may also be helpful to understand your potential risk. Although smoking is the leading cause of lung cancer (accounting for around 80 percent of lung cancer deaths) and many other lung cancer cases can be associated with secondhand smoke, there are several other causes of lung cancer besides smoking.

Other causes of lung cancer include chemicals or irritants that can cause inflammation in the lungs, eventually leading to the development of cancer. These can be found in the home, in workplaces, or just in the environment.

Radon

Radon is a radioactive gas that forms when uranium in rocks and soil breaks down. The Environmental Protection Agency has found that exposure to radon gas is the second leading cause of lung cancer, behind smoking.

Air Pollution

Exposure to exhaust and other chemical irritants in the air can lead to lung cancer. Around 5 percent of all lung cancer deaths may be caused by air pollution.

Asbestos

Asbestos is a fibrous material previously used to insulate old buildings. If inhaled, it can become trapped in the lungs and cause inflammation that leads to cancer.

Chemicals in the Workplace

Exposure to diesel exhaust, nickel, coal, chromium, and uranium can all increase the risk of developing lung cancer.

Family History

If you have a family history of lung cancer, especially in your parents or siblings, you are at an increased risk of developing lung cancer yourself. The increased risk may be due to shared genetic mutations, or it could be related to shared exposure to pollutants in the household.

Talk With Others Who Understand

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

Did you experience early symptoms of lung cancer as a nonsmoker? Share your experience in the comments below, or start a conversation by posting on MyLungCancerTeam.

Posted on July 13, 2021
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Mark Levin, M.D. is a hematology and oncology specialist with over 37 years of experience in internal medicine. Review provided by VeriMed Healthcare Network. Learn more about him here
Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here

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