Feeling Breathless? Don't Ignore Signs of Lung Cancer Symptoms

Lung cancer is a challenging disease that can affect anyone, but it is important to remember that each person’s condition is unique. While the symptoms and their onset vary depending on the tumor's location in the lung, it is essential to stay informed about the signs that could indicate the presence of lung cancer. The most common symptoms include persistent cough, coughing blood, chest pain, and shortness of breath. Patients may also experience back pain, a hoarse voice, and fluid accumulation around the lungs.

It is important to remember that detecting lung cancer symptoms early can improve patient treatment outcomes. Many patients are often asymptomatic until they develop advanced disease. Also, these symptoms have various causes and may not definitively indicate lung cancer.

Many lung cancer symptoms may be too vague to spot. You might associate them with certain lifestyle factors like smoking or stress from work. However, cancer symptoms are usually persistent and can only be relieved temporarily.

A cough that won’t go away. A persistent cough is present in 50-75% of lung cancer patients. It usually lasts for weeks and only responds temporarily to cough remedies. Patients with small cell and squamous cell carcinoma (a type of non-small cell lung cancer, NSCLC) may have an earlier onset of cough as the tumor often occurs near the main airway. The cough may either be dry or wet (with phlegm).

Many would assume the nagging cough is a result of other less concerning reasons:

• Allergies
• Irritation caused by dry, cold air
• Injury of the airway due to prolonged smoking – “smoker’s cough.”

It is best for smokers or former smokers to stay vigilant about the likelihood of lung cancer, especially when a new onset of cough emerges. A study encompassing 3,800 lung cancer patients found that those presenting with cough had better prognosis compared to those with other symptoms. When patients seek medical attention for new onset of cough, it may lead to incidental diagnosis of lung cancer at an earlier stage.

Shortness of breath (dyspnea). It may be inconspicuous, but shortness of breath occurs in 20-40% of lung cancer cases. Air humidity, aging, or being out of shape can easily be blamed for the symptoms. However, one should not experience frequent dyspnea even in a resting state. A decrease in lung function caused by cancer and airway obstruction by tumor can be the reason for difficulty breathing. Partial obstruction of the airway can cause wheezing.

Pain in the chest, back, shoulder, and arm. Lung tissue does not have pain receptors, but the lining around the lungs or structures do. Lung cancer pain starts when the tumor irritates nerves in the lung pleura or nearby structures:

• Chest pain: present in 20-40% of lung cancer patients. Pain is usually found on the side where the primary tumor is instead of all over the chest. Patients often complain about dull, persistent pain. Chest pain while breathing may worsen as they take deeper breaths.
• Back pain: It is often missed and mistaken as muscle strain. Caused by a tumor growing near the back, the cancer may spread to bones, the spine, or adrenal glands (small organs near the kidneys).
• Shoulder or arm pain: Caused by a tumor growing on the upper parts of the lungs – Pancoast tumor or the Pancoast syndrome. With a denser network of nerves running through the shoulder and arms, the pain can be awful and spread toward the head and neck or down to the fingers.

Coughing up blood (hemoptysis). Present in 15-30% of lung cancer patients, but it can be easily missed if the amount of blood is too little. Nevertheless, any amount of blood from coughing should be alarming to anyone, and they should seek medical care immediately. Lung cancer-causing hemoptysis can be life-threatening and it requires emergency medical attention.

• If you are a smoker or ex-smoker and have the symptoms mentioned above
• If you have never smoked but suffer from the above symptoms for an extended period
• If you have a family history of lung cancer and have been experiencing the above symptoms for an extended period
• If you are constantly exposed to other risk factors of lung cancer and are experiencing the above symptoms

While these symptoms can be due to other causes besides lung cancer, getting a timely diagnosis and treatment is key. Earlier detection improves outcomes and leads to a path of hope and recovery. Do not delay seeing a doctor if you experience these symptoms.