You’ve had a bad cough for weeks and your chest hurts every time you breathe. It doesn’t seem to be going away and you think it is getting worse. Is it just a cold? Pneumonia or bronchitis? Or could it mean something as serious as lung cancer?
Is your cough a symptom, a sign, or will it be the diagnosis the doctor writes on your insurance form? These terms, often used interchangeably, can be confusing. A symptom is a change in the body that is indicative of disease, injury or that something is “just not right” with the bodily systems. A symptom is something you notice yourself, such as your cough or a sore throat. A sign is something that your doctor will observe like a fever or a rattle in the chest heard with a stethoscope. Diagnosis is the final recognition of a disease or condition after all of the signs and symptoms have been taken into account.
Unfortunately, lung cancer, much like other forms of asbestos cancer such as mesothelioma, is a disease that usually does not produce symptoms and is therefore not recognized until it is advanced in its development. In fact, over 90% of adults who are diagnosed have no symptoms at all. Often, people who are diagnosed with lung cancer look back and realize they had some symptoms for a long period of time, but did not connect them with anything serious enough to cause them to see a doctor.
The symptoms of lung cancer are varied and depend on the type and size of any tumors and their location in the body. As the cancer progresses, it can affect many organs and bodily systems and cause symptoms not related to the chest or lungs. Because treatment and prognosis are entirely dependent on the stage of the disease when it is diagnosed, the earlier lung cancer can be detected, the more favorable the outcome.
One very noticeable and common symptom of lung cancer is an unexplained or persistent cough. Cough is present in 65-75% of diagnosed patients and its ongoing presence is usually what causes people to ultimately seek medical attention.
Other symptoms in the respiratory system include:
- Hemoptysis, or coughing up blood, even if in small amounts or it resolves quickly;
- Chest pain. It may be a constant dull ache or may rise and fall with breathing patterns.
- Dyspnea, or shortness of breath or wheezing.
- Hoarseness, meaning your voice may be raspy, breathy or strained and you may not be able to speak very loudly.
Patients often do not associate symptoms that aren’t related to the respiratory system with lung cancer. However, some symptoms will develop even before chest or breathing problems become noticeable, such as:
- Pain in the shoulder or numb or suddenly weak arms or hands. Often if cancer is located towards the top of a lung (towards the collarbone), it may grow into the nerve supply of the arm causing pain, as well as arm weakness and numbness.. The combination of these symptoms is called Pancoast syndrome.
- Anorexia or loss of appetite. You may also have a hard time swallowing or feel like you are tasting or smelling things differently; for instance, you may experience a metallic taste to in your mouth or suddenly dislike foods that were normally your favorites.
- Clubbing. The tips of your fingers or toes may suddenly seem swollen and curve downwards. The nail beds become soft, thick and shiny and the skin around the nail beds seems pulled tight.
- Unexplained weight loss, despite eating well and not “trying” to lose weight. This may be caused by malignant cells utilizing all of the available energy supply in the body or producing changes in metabolism.
- Swelling of the face, neck and arms. This is often a sign of a condition called superior vena cava syndrome (SVCS) in which a tumor is pressing on the large, short vein in the chest that carries de-oxygenated blood to the heart from the upper body. Other symptoms that can accompany swelling include droopy eye lid and pupillary constriction.
Some symptoms of lung cancer can be mistaken for other common illnesses and might not necessarily alert you to a serious problem. Often these are called “general” or “non-specific” symptoms. Some of these are:
- Nausea or vomiting
- Bone pain or achiness
More rarely seen in lung cancer patients, paraneoplastic syndromes are a group of symptoms in organs that do not contain and are not obstructed by a cancerous tumor. It is believed that these syndromes are caused by the malignant tumors releasing hormones and proteins into the blood, which then flows to the various organs. In some cases, these syndromes may appear very early in the development of lung cancer and can assist with diagnosis.
Some lung cancer tumors produce substances that disturb the normal growth of blood cells and platelets and produces symptoms such as:
- Excess platelets in the blood (thrombocytosis) which can cause blood clots or, alternatively, too few platelets, which can cause tiny visible bruises and blood “blisters” called pupura
- Abnormal blood protein functioning and levels
Finally, certain types of lung cancer tumors can affect the circulatory system, cause skin conditions, neurological symptoms and even affect organs within the brain itself, such as the pituitary gland and the hypothalamus.
When you visit your doctor with symptoms, he will need to obtain detailed information from you that will help determine your risk for lung cancer. Past medical conditions and diseases and any family occurrences of cancer should be discussed. He should also take a comprehensive occupational and environmental history to see if you have been exposed to any chemicals or cancer-causing substances in your job duties.
It is apparent that the variety and range of symptoms caused by lung cancer is wide. Because early detection is vital to your prognosis and successful treatment, it is important to be aware of the key symptoms of the disease and to seek prompt medical attention.