Non-Small Cell Lung Cancer (NSCLC)
People with NSCLC may experience the following symptoms or signs. Sometimes people with NSCLC do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer.
- Shortness of breath
- Chest and other unexplained pain, if a tumor spreads to the lining of the lung or other parts of the body near the lungs
- Loss of appetite
- Coughing up phlegm or mucus
- Coughing up blood
If you are concerned about one or more of the symptoms or signs on this list, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.
For people with NSCLC who have no symptoms, the cancer may be noticed on a chest x-ray or CT scan performed for some other reason, such as checking for heart disease. Most people with NSCLC are diagnosed when the tumor grows, takes up space, or begins to cause problems with parts of the body near the lungs. A lung tumor may also make fluid that can build up in the lung or the space around the lung or push the air out of the lungs and cause the lung to collapse. This prevents oxygen from getting in the body and carbon dioxide from leaving the body by blocking the flow of air into the lungs, or by using up the space normally required for oxygen to come in and carbon dioxide to go out of the lung.
NSCLC can spread anywhere in the body through a process called metastasis. It most commonly spreads to the lymph nodes, other parts of the lungs, bones, brain, liver, and structures near the kidneys called the adrenal glands. Metastases from NSCLC can cause:
- More breathing difficulties
- Bone pain
- Abdominal or back pain
- Speech difficulties
- Rarely, a lung tumor can release hormones that cause problems such as low blood sodium levels or high blood calcium levels.
Symptoms such as fatigue, feeling out-of-sorts or unwell, and loss of appetite are not necessarily caused by metastases. Cancer anywhere in the body can cause a person to feel unwell in a general way. Loss of appetite can cause weight loss. Fatigue and weakness can further worsen a person’s ability to breathe.
If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.
Small Cell Lung Cancer
Most lung cancers do not cause any symptoms until they have spread, but some people with early lung cancer do have symptoms. If you go to your doctor when you first notice symptoms, your cancer might be diagnosed at an earlier stage, when treatment is more likely to be effective.
Most of these symptoms are more likely to be caused by something other than lung cancer. Still, if you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated, if needed. The most common symptoms of lung cancer are:
- A cough that does not go away or gets worse
- Coughing up blood or rust-colored sputum (spit or phlegm)
- Chest pain that is often worse with deep breathing, coughing, or laughing
- Weight loss and loss of appetite
- Shortness of breath
- Feeling tired or weak
- Infections such as bronchitis and pneumonia that don’t go away or keep coming back
- New onset of wheezing
When lung cancer spreads to other parts of the body, it may cause:
- Bone pain (like pain in the back or hips)
- Nervous system changes (such as headache, weakness or numbness of an arm or leg, dizziness, balance problems, or seizures), from cancer spread to the brain
- Yellowing of the skin and eyes (jaundice), from cancer spread to the liver
- Lumps near the surface of the body, due to cancer spreading to the skin or to lymph nodes (collection of immune system cells) such as those in the neck or above the collarbone
Some lung cancers can cause syndromes, which are groups of specific symptoms.
Cancers of the upper part of the lungs are sometimes called Pancoast tumors. These tumors are more likely to be non-small cell lung cancer (NSCLC) than small cell lung cancer (SCLC).
Pancoast tumors can affect certain nerves to the eye and part of the face, causing a group of symptoms called Horner syndrome:
- Drooping or weakness of one eyelid
- A smaller pupil (dark part in the center of the eye) in the same eye
- Reduced or absent sweating on the same side of the face
Pancoast tumors 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 back to the heart. It passes next to the upper part of the right lung and the lymph nodes inside the chest. Tumors in this area can press on the SVC, which can cause the blood to back up in the veins. This can lead to swelling in the face, neck, arms, and upper chest (sometimes with a bluish-red skin color). It can also cause headaches, dizziness, and a change in consciousness if it affects the brain. While SVC syndrome can develop gradually over time, in some cases it can become life-threatening, and needs to be treated right away.
Some lung cancers make hormone-like substances that enter the bloodstream and cause problems with distant tissues and organs, even though the cancer has not spread to those tissues or organs. These problems are called paraneoplastic syndromes. Sometimes these syndromes may be the first symptoms of lung cancer. Because the symptoms affect other organs, patients and their doctors may first suspect that a disease other than lung cancer is causing them.
Some of the more common paraneoplastic syndromes associated with SCLC are:
- SIADH (syndrome of inappropriate anti-diuretic hormone): In this condition, the cancer cells make a hormone (ADH) that causes the kidneys to retain (hold) water. This lowers salt levels in the blood. Symptoms of SIADH can include fatigue, loss of appetite, muscle weakness or cramps, nausea, vomiting, restlessness, and confusion. Without treatment, severe cases may lead to seizures and coma.
- Cushing syndrome: In this condition, the cancer cells make ACTH, a hormone that makes the adrenal glands secrete cortisol. This can lead to symptoms such as weight gain, easy bruising, weakness, drowsiness, and fluid retention. Cushing syndrome can also cause high blood pressure and high blood sugar levels, or even diabetes.
- Nervous system problems: SCLC can sometimes cause the body’s immune system to attack parts of the nervous system, which can lead to problems. One example is a muscle disorder called Lambert-Eaton syndrome. In this syndrome, muscles around the hips become weak. One of the first signs may be trouble getting up from a sitting position. Later, muscles around the shoulder may become weak. A rarer problem is paraneoplastic cerebellar degeneration, which can cause loss of balance and unsteadiness in arm and leg movement, as well as trouble speaking or swallowing. SCLC can also cause other nervous system problems, such as muscle weakness, sensation changes, vision problems, or even changes in behavior.
Again, many of these symptoms can also be caused by something other than lung cancer. Still, if you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated, if needed.
Source: American Cancer Society