Non-Small-Cell Lung Cancer (cont.)
Koyamangalath Krishnan, MD, FRCP
NonSmall-Cell Lung Cancer Symptoms
The symptoms of lung cancer are caused by the primary tumor or by metastatic disease. The primary tumor may press on, infiltrate, or damage surrounding tissues, blood vessels, or nerves. Metastatic lung cancer may cause similar problems in other parts of the body. As many as 10% of people with lung cancer have no symptoms. Their cancers are detected on chest x-ray films performed for other reasons.
The symptoms depend on the primary tumor’s size, its location in the lung, the surrounding areas affected by the tumor, and the sites of tumor metastasis, if any. Symptoms related to the primary tumor may include any of the following:
- Shortness of breath
- Difficulty taking a deep breath
- Coughing or spitting blood (hemoptysis)
- Pneumonia or other recurrent respiratory infection
- Pain in the chest, side, or back (usually due to infiltration by the tumor of areas surrounding the lungs)
- Hoarseness, difficulty swallowing, or other symptoms in the face, neck, or arms due to infiltration by a tumor
Symptoms of metastatic lung tumors depend on location and size. Lung cancer most often spreads to the liver, the adrenal glands, the bones, and the brain. About 30-40% of people with lung cancer have some symptoms or signs of metastatic disease.
- Metastatic lung cancer in the liver usually does not cause any symptoms, at least at the time of diagnosis.
- Typically, metastatic lung cancer in the adrenal glands also causes no symptoms at the time of diagnosis.
- Metastasis to the bones is most common with small cell lung cancer but can occur with NSCLC. Lung cancer that has metastasized to the bone causes deep pain, usually in the backbone (vertebrae), thighbones, and ribs.
- Lung cancer that spreads to the brain can cause difficulties with vision, weakness on one side of the body, seizures, or a combination thereof.
- Weight loss may be a symptom of metastatic disease.
Paraneoplastic syndromes are conditions that the disease causes indirectly. These are less common with NSCLC than with small cell lung cancers, but they do occur.
- High level of calcium in the blood (hypercalcemia) - Can cause problems with muscle and nerve functioning
- Increased production of one or more hormones
- Increased blood coagulation (hypercoagulability) - Increases risk of blood clots
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