Lung cancer is tricky. Many people don’t realize they have it until it’s advanced because symptoms often stay hidden until the later stages. The good news is that thanks to newer screening tools, it’s now possible to catch lung cancer earlier, before symptoms even start. For those at higher risk — such as people with a history of heavy smoking — a simple chest CT scan could be a lifesaver.

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 about 87 percent of lung cancer diagnoses, and SCLC makes up 13 percent. NSCLC and SCLC overlap quite a bit in their common symptoms, which can develop in almost all areas of the body.

Respiratory Symptoms

Respiratory symptoms associated with lung cancer include:

• Change in sputum (mucus or phlegm) color
• Hemoptysis (coughing up blood)
• Hoarseness
• Increased sputum production
• Persistent cough
• Recurrent lung infections, such as pneumonia or lung abscess
• 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’ve 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:

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

General Symptoms

Other symptoms and signs of lung cancer — or of it metastasizing (spreading) to other parts of the body — can include:

• Balance problems
• Leg pain or numbness, which can be due to blood clots
• Bones that fracture easily
• Cachexia (muscle wasting)
• Dizziness
• Fatigue
• Malaise (feeling of discomfort, illness, or uneasiness)
• Jaundice (yellowing of the skin and eyes), which points to issues with the liver
• Loss of appetite
• Memory loss
• Seizures, if lung cancer has spread to the brain
• Unexplained weight loss
• Weakness
• Swollen lymph nodes — Lymph nodes are small, bean-shaped structures located throughout the body that help your body fight infection.

Superior Vena Cava Syndrome

Lung cancer can cause syndromes, which are sets of specific symptoms that occur together. The superior vena cava (SVC) is a large vein that returns blood from the head, neck, arms, and chest to the heart. SVC syndrome can develop if a tumor becomes too large and presses on this vein. The pressure prevents blood from flowing through and leads to swelling in the face, neck, arms, and chest.

Additional signs of SVC syndrome include:

• Difficulty breathing
• Dizziness
• Headaches
• Skin discoloration — On lighter skin, this often appears as a bluish-red color. On darker skin, the changes may be more subtle, showing up as an ashen, grayish, or dusky tone.

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 parts of the body such as the nervous system instead of cancer cells.

Paraneoplastic syndromes usually affect middle-aged to older people. Paraneoplastic syndromes are uncommon overall but are more frequently seen in people with small-cell lung cancer and may be serious or life-threatening.

Symptoms of paraneoplastic syndromes affecting the nervous system 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

Several types of paraneoplastic syndromes 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
• Unintentional weight gain
• Bruising
• Fluid buildup
• Hypertension (high blood pressure)
• High blood glucose (sugar) levels, which in some cases can lead to 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 also become weak.

Paraneoplastic Cerebellar Degeneration

Paraneoplastic cerebellar degeneration affects the part of the brain responsible for balance and coordination. This can 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 cramping
• Confusion
• Restlessness

If not treated, severe cases can lead to seizures and coma.

Non-Small Cell Lung Cancer Symptoms

Paraneoplastic syndromes can develop in some cases of NSCLC, though they’re more commonly seen with SCLC. Examples of such syndromes include hypertrophic osteoarthropathy and hypercalcemia.

Hypertrophic Osteoarthropathy

Hypertrophic osteoarthropathy — sometimes called “clubbing” — is characterized by joint swelling and pain, arthritis, and inflammation of the connective tissue that surrounds bones. This usually affects the joints of the hands.

When hypertrophic osteoarthropathy develops by itself because of genetic mutations (gene changes or variants), it’s called primary hypertrophic osteoarthropathy. When it’s caused by another disease, such as lung cancer, it’s called secondary hypertrophic osteoarthropathy.

Hypercalcemia

Hypercalcemia is a condition defined by high levels of calcium in the blood. It may develop when lung cancer cells spread to the bone. This spread of lung cancer cells leads the bone to break down and calcium to be released into the bloodstream. Sometimes, lung cancer can also release a hormone that increases calcium in the blood.

Symptoms of hypercalcemia include:

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

Horner’s Syndrome

When lung cancer is found in the upper part of the lungs, it is called a Pancoast tumor. These tumors 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 cancer can be stressful. In fact, up to 25 percent of people 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’re 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 the side effects of chemotherapy, radiation therapy, immunotherapy, 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’re being treated for lung cancer, keeping open communication with your doctor is key. Share any new or worsening symptoms right away so your care team can help manage them early. Staying involved in your treatment can make a big difference in how you feel and help you manage side effects more effectively.

Find Your Team

On MyLungCancerTeam, people share their experiences with lung cancer, get advice, and find support from others who understand.

What’s one thing you wish more people knew about living with lung cancer? Let others know in the comments below.