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Symptoms of Lung Cancer

Updated on April 07, 2021
Medically reviewed by
Todd Gersten, M.D.
Article written by
Emily Wagner, M.S.

Lung cancer symptoms occur when a tumor starts damaging the lung or pressing against nearby tissues or organs. Most often, lung cancer symptoms do not appear until the disease has progressed into the late stages. Early stage lung cancer diagnosis is uncommon, due to a lack of lung cancer screening methods.

Common Lung Cancer Symptoms

The two main types of lung cancer are non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Overall, NSCLC accounts for 84 percent of lung cancer diagnoses, and SCLC for 13 percent. NSCLC and SCLC overlap quite a bit in their common symptoms, which can be experienced in almost all parts of the body.

Respiratory Symptoms

Respiratory symptoms associated with lung cancer include:

  • Change in sputum (mucus or phlegm) color
  • Coughing up blood (hemoptysis)
  • Hoarseness
  • Increased sputum production
  • Persistent cough
  • Recurring lung infections, such as bronchitis or pneumonia
  • Shortness of breath
  • Wheezing
  • Chest pain that worsens with laughing, coughing, or deep breathing

Some environmental factors that may increase your risk of developing lung cancer include exposure to asbestos, radon, and secondhand smoke. If you begin experiencing symptoms of lung cancer and you have been exposed to these risk factors, talk with your doctor about your concerns.

Pain

A possible sign of lung cancer includes pain in any of these areas:

  • Back
  • Bones
  • Head (headaches)
  • Joints
  • Shoulders

General Symptoms

Other symptoms of lung cancer, or the spread of lung cancer to other sites in the body, can include:

  • Balance problems
  • Blood clots
  • Bone fractures
  • Cachexia (muscle wasting)
  • Dizziness
  • Fatigue
  • Malaise
  • Jaundice (yellowing of the skin and eyes), which is indicative of issues with the liver
  • Loss of appetite
  • Memory loss
  • Seizures, if lung cancer has metastasized to the brain
  • Unexplained weight loss
  • Anorexia
  • Weakness
  • Swollen lymph nodes

Superior Vena Cava Syndrome

Lung cancer can cause syndromes, or groupings of specific symptoms. The superior vena cava (SVC) is a large vein responsible for returning blood flow from the head, neck, arms, and chest to the heart. SVC syndrome can occur if a tumor becomes too large and presses on the vein. This prevents blood from flowing through, and leads to swelling in the face, neck, arms, and chest. Additional signs of SVC syndrome include dizziness, headaches, and bluish-red coloring of the skin.

Small Cell Lung Cancer Symptoms

Rarely, people with SCLC will develop signs and symptoms of paraneoplastic syndromes, a group of disorders that are triggered by hormones released by the cancer or an abnormal immune response to cancer. For example, cancer-specific antibodies and other immune cells may mistakenly attack the nervous system instead of cancer cells. Paraneoplastic syndromes usually affect middle-aged to older people. While rare overall, paraneoplastic syndromes are more common in cases of small cell lung cancer.

Symptoms of paraneoplastic syndromes include:

  • Loss of muscle tone
  • Slurred speech
  • Loss of fine motor skills
  • Vision problems
  • Difficulty walking
  • Seizures
  • Difficulty swallowing
  • Sleep disturbances
  • Vertigo or dizziness
  • Sensory loss in the arms and legs
  • Dementia

There are several types of paraneoplastic syndromes that may occur in people with SCLC.

Paraneoplastic Cushing’s Syndrome

In Cushing’s syndrome, cancer cells make a hormone that causes the adrenal glands to produce cortisol, a stress hormone. Symptoms include weakness, drowsiness, weight gain, bruising, fluid buildup, high blood pressure, high blood sugar levels, and in some cases, diabetes.

Lambert-Eaton Syndrome

In Lambert-Eaton syndrome the muscles surrounding the hips become weak, making it difficult to stand up from a sitting position. Over time, the muscles around the shoulders may become weak as well.

Paraneoplastic Cerebellar Degeneration

This condition causes a loss of balance, unsteady arm and leg movements, and difficulty swallowing or speaking.

Syndrome of Inappropriate Antidiuretic Hormone Secretion

In syndrome of inappropriate antidiuretic hormone secretion (SIADH), cancer cells make a hormone that causes the kidneys to hold water, lowering salt levels in the blood. Symptoms of SIADH include loss of appetite, fatigue, nausea and vomiting, muscle weakness or cramps, confusion, and restlessness. If not treated, severe cases can lead to seizures and coma.

Non-Small Cell Lung Cancer Symptoms

It is possible to develop paraneoplastic syndromes in some cases of NSCLC, but less so than in cases of SCLC. Examples of such syndromes include hypertrophic osteoarthropathy and hypercalcemia.

Hypertrophic Osteoarthropathy

Hypertrophic osteoarthropathy (HO) — sometimes called "clubbing" — is characterized by joint swelling and pain, arthritis, and inflammation of the connective tissue that surrounds bones. When HO occurs on its own due to genetic mutations, it is called primary HO. When it is caused by another disease, such as lung cancer, it is called secondary HO.

Hypercalcemia

Hypercalcemia is a condition defined by high levels of calcium in the blood. It may occur when lung cancer cells spread to the bone. This leads the bone to break down, and calcium is released into the bloodstream. Symptoms of hypercalcemia include:

  • Thirst
  • Constipation
  • Frequent urination
  • Belly pain
  • Nausea and vomiting
  • Fatigue
  • Weakness
  • Dizziness
  • Confusion

Horner’s Syndrome

Pancoast’s tumors are a type of NSCLC found in the upper part of the lungs. They can affect certain nerves in parts of the face and eyes, causing a condition called Horner’s syndrome. This is not a paraneoplastic syndrome. Symptoms include:

  • Drooping or weakness of one upper eyelid
  • Decreased pupil size
  • Decreased sweating on the affected side of the face

Depression and Anxiety

Living with a chronic condition like cancer can be stressful. In fact, between 15 percent and 25 percent of people living with cancer are affected by depression. According to the National Institute of Mental Health, people with chronic illnesses are much more likely to develop depression. Feelings of anxiety, worry, and stress about living with cancer can all trigger depression.

If you are struggling with a lung cancer diagnosis, there are ways to cope with your emotions and manage your mental health. Therapists and other mental health professionals are available to work with clients who have chronic and life-threatening diseases.

Lung Cancer Symptom or Treatment Side Effect?

It may be difficult to tell the difference between symptoms of lung cancer and side effects of chemotherapy, radiation therapy, targeted therapy, or other treatments used to treat it. Some symptoms you may experience are more likely to be side effects of treatment options rather than symptoms directly caused by lung cancer. These include:

  • Hair loss
  • Sores in the mouth or on the tongue
  • Dry or irritated skin
  • Changes in blood pressure levels
  • Diarrhea or constipation

If you experience any new or worsening symptoms while on treatment, talk to your doctor about them.

Lung Cancer Condition Guide

References

  1. Key Statistics for Lung Cancer — American Cancer Society
  2. If You Have Non-Small Cell Lung Cancer — American Cancer Society
  3. If You Have Small Cell Lung Cancer — American Cancer Society
  4. Signs and Symptoms of Lung Cancer — American Cancer Society
  5. Lung Cancer — Non-Small Cell: Statistics — Cancer.net
  6. Lung Cancer — Small Cell: Statistics — Cancer.net
  7. Non-Small Cell Lung Cancer Treatment — National Cancer Institute
  8. Small Cell Lung Cancer Treatment — National Cancer Institute
  9. Superior Vena Cava Syndrome — StatPearls
  10. Paraneoplastic Syndromes Information Page — National Institute of Neurological Disorders and Stroke
  11. Secondary Hypertrophic Osteoarthropathy — StatPearls
  12. Hypercalcemia — Mayo Clinic
  13. Horner Syndrome — Mayo Clinic
  14. Depression — National Cancer Institute
  15. Chronic Illness & Mental Health — National Institute of Mental Health
  16. Coping With Emotions When You Have Lung Cancer — American Lung Association
  17. Chemotherapy Side Effects — American Cancer Society
  18. Radiation Therapy Side Effects — American Cancer Society
  19. Targeted Drug Therapy for Non-Small Cell Lung Cancer — American Cancer Society
Todd Gersten, M.D. is a hematologist-oncologist at the Florida Cancer Specialists & Research Institute in Wellington, Florida. 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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