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Lung Cancer (cont.)

Lung Cancer Symptoms and Signs

Up to one-fourth of all people with lung cancer may have no symptoms when the cancer is diagnosed. These cancers usually are identified incidentally when a chest X-ray is performed for another reason. The majority of people, however, develop symptoms. The symptoms are due to direct effects of the primary tumor, to effects of metastatic tumors in other parts of the body, or to disturbances of hormones, blood, or other systems caused by the cancer.

Symptoms of primary lung cancers include cough, coughing up blood, chest pain, and shortness of breath.

  • A new cough in a smoker or a former smoker should raise concern for lung cancer.
  • A cough that does not go away or gets worse over time should be evaluated by a health-care provider.
  • Coughing up blood (hemoptysis) occurs in a significant number of people who have lung cancer. Any amount of coughed-up blood is cause for concern.
  • Chest pain is a symptom in about one-fourth of people with lung cancer. The pain is dull, aching, and persistent.
  • Shortness of breath usually results from a blockage to the flow of air in part of the lung, collection of fluid around the lung (pleural effusion), or the spread of tumor throughout the lungs.
  • Wheezing or hoarseness may signal blockage or inflammation in the lungs that may go along with cancer.
  • Repeated respiratory infections, such as bronchitis or pneumonia, can be a sign of lung cancer.

Symptoms of metastatic lung tumors depend on the location and size. About 30% to 40% of people with lung cancer have some symptoms or signs of metastatic disease.

  • Lung cancer most often spreads to the liver, the adrenal glands, the bones, and the brain.
  • Metastatic lung cancer in the liver usually does not cause symptoms, at least up to the time of diagnosis.
  • Metastatic lung cancer in the adrenal glands also typically causes no symptoms.
  • Metastasis to the bones is most common with small cell cancers but also occurs with other lung cancer types. Lung cancer that has metastasized to the bone causes bone pain, usually in the backbone (vertebrae), the thighbones, and the ribs.
  • Lung cancer that spreads to the brain can cause difficulties with vision, weakness on one side of the body, and/or seizures.

Paraneoplastic syndromes are the remote, indirect effects of cancer not related to direct invasion of an organ by tumor cells. Often they are caused by chemicals released from the cancers. Symptoms include the following:

  • Clubbing of fingers -- the depositing of extra tissue under the fingernails
  • New bone formation -- along the lower legs or arms
  • Anemia -- low numbers of red blood cells and high calcium level or low sodium level in the blood
  • Other effects -- muscle weakness, skin rashes, and degeneration of the brain
  • Weight loss
  • Fatigue
  • Low sodium levels

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