Signs and Symptoms associated with Lung Cancer

As part of our continued support of Lung Cancer Awareness Month, we’re going to use this issue of our weekly blog to take a look at the signs and symptoms normally associated with lung cancer and the impacts these may have on the body.

In many instances, lung cancers do not cause any symptoms until they have spread, but for some people with early lung cancer, symptoms do appear.

The most common symptoms of lung cancer can include:

  • A continuous cough that does not go away or gets worse
  • Coughing up blood or rust-coloured sputum (spit or phlegm)
  • Chest pains that are often worse with deep breathing, coughing, or when laughing
  • Hoarseness
  • Loss of appetite
  • Unexplained weight loss
  • Shortness of breath
  • Feeling tired or weak
  • Infections such as bronchitis and pneumonia that never go away or keep coming back
  • New onset of wheezing

If lung cancer spreads to other parts of the body, it may cause some of the following:

  • Joint and bone pain in the back or hips
  • Changes to the nervous system, that might include headaches, weakness or numbness in the arm or leg, dizziness, balance problems, or seizures from where cancer has spread to the brain
  • Yellowing of the skin and eyes (jaundice), from where cancer has spread to the liver
  • Swelling of lymph nodes, which are a collection of immune system cells found in the neck or above the collarbone

Some lung cancers can cause characteristics or syndromes, that collect as groups of specific symptoms, and these can include.

Horner syndrome

Cancers in the upper part of the lungs are often referred to as Pancoast tumours. These tumours are more commonly associated with non-small cell lung cancer (NSCLC) than small cell lung cancer (SCLC).

Pancoast tumours can affect various nerves to the eye along with parts of the face, causing a collection of symptoms that are known as Horner syndrome, which can lead to;

  • Drooping or weakness in one upper eyelid
  • A smaller pupil (the dark part in the centre of the eye) in the same eye
  • No or little sweating on the same side of the face

Plus, Pancoast tumours can also sometimes cause severe shoulder pain.

Superior vena cava syndrome

The superior vena cava (SVC) is a large vein that carries blood from the head and arms down to the heart, that passes next to the upper part of the right lung and the lymph nodes inside the chest.

When tumours in this area press on the SVC, it can cause the blood to back up in the veins, this can lead to swelling in the face, neck, arms, and upper chest, leaving a bluish-red skin colour.

It can also lead to headaches, dizziness, and a change in consciousness if it affects the brain. While SVC syndrome can develop gradually over time, in some instances, it can become life-threatening, and requires immediate treatment.

Paraneoplastic syndromes

Some lung cancers can make a hormone-like substance that enters the bloodstream and cause problems with remote tissues and organs, even though the cancer has not spread to those places.

These problems are called Paraneoplastic syndromes, and in some cases, may well be the first symptoms of lung cancer, and because the symptoms can affect other organs, a disease other than lung cancer may well be first suspected as causing them.

Paraneoplastic syndromes can happen with any lung cancer but are more often associated with SCLC. Some common syndromes include:

  • SIADH (syndrome of inappropriate anti-diuretic hormone): In this instance, the cancer cells make ADH, a hormone that causes the kidneys to hold water, which lowers the salt levels in the blood. Symptoms of SIADH often include fatigue, loss of appetite, muscle weakness or cramps, nausea, vomiting, restlessness, and confusion. Without treatment, severe cases can lead to seizures and coma.
  • Cushing syndrome: Is where the cancer cells make ACTH, a hormone that causes the adrenal glands to create cortisol, which can lead to symptoms such as an increase in weight, easy bruising, fatigue and weakness, drowsiness, and fluid retention. It can also cause high blood pressure, increase in blood sugar levels, or even diabetes.
  • Nervous system problems: In cases of SCLC, the body’s immune system attacks part of the nervous system, which can lead to several issues arising. For example, a muscle disorder called Lambert-Eaton syndrome, where the muscles around the hips become weak. Early signs of this may be trouble getting up from a sitting position. While later, the muscles around the shoulder may become weak.
  • Paraneoplastic cerebellar degeneration is less common and may cause loss of balance along with unsteadiness in arm and leg movement, along with trouble speaking or swallowing.

Small cell lung cancer (SCLC) can also cause other nervous system problems, such as muscle weakness, sensation changes, vision problems, or even changes in personality and behaviour. While high levels of calcium in the blood (hypercalcemia), which can cause frequent urination, thirst, constipation, nausea, vomiting, belly pain, weakness, fatigue, dizziness, and confusion along with blood clots.

As a word of caution. Many of these symptoms are more likely to be caused by something other than lung cancer. However, if you are suffering from any of these problems. It is important to speak with your doctor, so the cause can be identified and treated. As with all cases of cancer, early detection is critical.

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