Early symptoms of lung cancer

Lung cancer symptoms

Most people do not experience early symptoms of lung cancer. Instead they become aware of symptoms when the tumor has spread beyond treatment. On the other hand, symptoms may take place in early stage lung cancer, alerting the patient and leading to a timely diagnosis, early treatment and better chances of survival. Additionally, lung cancer in people with no symptoms may be detected on a chest x-ray, CT scan, sputum exam, or bronchoscopy performed for unrelated reasons. Whether symptoms appear early or late, palliative or supportive care is essential for symptom management.

Common symptoms of lung cancer include:

·         Cough that does not go away or worsens over time.

·         Chest pain that intensifies with deep breathing, coughing, or laughing.

·         Hoarseness.

·         Loss of appetite.

·         Loss of weight.

·         Shortness of breath.

·         Fatigue or weakness.

·         Recurring infections (bronchitis, pneumonia).

·         New onset of wheezing.

·         Coughing up phlegm, mucus, or blood.

·         Bone pain.

·         Headache.

Lung cancer can be found early through screening, especially in people who smoke or who have been overly exposed to secondhand smoke, radon, and asbestos and other chemicals such as arsenic, chromium, or nickel. The American Cancer Society and the American Society of Clinical Oncology (ASCO), based on The National Lung Screening Trial, recommend a yearly low dose CT scan for people who:

·         Are 55-74 years old

·         Are in fairly good health

·         Have smoked for at least 30 pack years*, and

·         Are still smoking or have quit in the past 15 years.

*One pack year equals one pack (20 cigarettes) a day every year (approximately 7,305 cigarettes a year).

Additionally, the U.S. Preventive Services Task Force recommends people aged 55-80 and who have smoked for 30 pack years or more or have quit in the last 15 years to undergo low dose CT scans every year until they have not smoked for 15 years. Screening should also stop if the person develops a life-shortening medical issue that might prevent them from having surgery for lung cancer. CT scan is not recommended for every person who smokes or for people who have a smoking history of less than 30 pack years, are younger than 55 or older than 74, have quit more than 15 years ago, or have a condition that could affect treatment.

A CT scan is a tridimensional imaging test that enables doctors to assess the size and location of a lung tumor and whether it has spread to other parts of the body. Unlike an x-ray, which takes a single picture, the CT scan rotates around the body to take multiple pictures that are later combined into a detailed, cross-sectional view. CT scans are also more effective and accurate than x-rays at showing tumors and their size, shape and position. However, this is not the only diagnostic test. Others include:



Chest x-ray

Usually the first test to look for masses or spots on the lungs. Some lung cancers don’t appear on x-rays.

Positron emission tomography (PET) scan


Magnetic resonance imaging (MRI) scan

Used rarely because of limited capacity to take pictures of moving body parts like the lungs.

Bone scan


Sputum cytology

A microscopic analysis of mucus or phlegm from the lungs coughed up by the patient.


A thin, flexible tube with a light on the end is passed into the mouth or nose, through the main airway, and into the breathing passages of the lungs.


Needle aspiration/core biopsy.

Bone marrow aspiration and biopsy.


The skin on the chest is numbed and a needle inserted into the space between the lung and chest wall to collect fluid samples for testing.


A surgeon makes an incision in the chest of a patient under general anesthesia to examine the lung and collect tissue samples. Also used to remove a tumor.


A special instrument and a small video camera are introduced through an incision in the skin of the chest wall.


A small incision is made at the top of the breastbone to examine and collect samples of lymph nodes.


These tests can help determine the type and stage of lung cancer. There are two types of lung cancer:

·         Non-small cell lung cancer. The most common type, it starts in the epithelial cells. It is divided in three subtypes:

-        Adenocarcinoma if it starts in the cells that produce mucus.

-        Squamous or epidermoid carcinoma if it starts in the cells lining the airways.

-        Large cell carcinoma if it starts in any other cells than the preceding two classes.

·         Small cell lung cancer. It starts in the nerve cells or hormone-producing cells of the lung.  

Both types of cancer are staged from 0 through I-IV.




Also known as in situ disease. The cancer is in place and has not grown into nearby tissues or spread outside the lung.


A surgically removable small tumor that hasn’t spread to any lymph nodes.

·         Stage IA. Tumor is less than 3cm in greatest dimension and has not spread to any lymph nodes.

·         Stage IB. More than 3cm but less than 5cm and hasn’t spread to any lymph nodes.


·         Stage IIA. Tumor is larger than 5cm but less than 7cm wide and has not spread to any lymph nodes, or less than 5cm wide but has spread to nearby lymph nodes.

·         Stage IIB. Larger than 5cm but less than 7cm and has spread to lymph nodes, or more than 7cm wide and may or may not grown into nearby structures but not to the lymph nodes.


The tumor may have spread to the lymph nodes in the center of the chest outside the lung or grown into nearby structures, making it difficult, if not impossible, to remove.


Tumor has metastasized to more than one area in the other lung, the fluid surrounding the lung or the heart, or distant body parts like the brain, bones, liver, or adrenal glands through the bloodstream.

·         IVA. Tumor has spread within the chest.

·         IVB. It has spread outside of the chest.


Sometimes the early symptoms of lung cancer are dismissed as the consequences of long-term smoking. Conversely, being diagnosed with lung cancer could certainly scare someone straight into quitting smoking. Others might think it is too late to quit. The fact is that smoking cessation can help patients tolerate therapy better, as well as feel better, live longer, and reduce the risk of a second lung cancer. Treatment for lung cancer includes:


Adjuvant therapy

·         Wedge resection

·         Lobectomy

·         Segmentectomy

·         Pneumonectomy

·         Radiofrequency ablation

·         Radiation therapy

·         Chemotherapy

·         Targeted therapy

-        Bevacizumab

-        Erlotinib

-        Crizotinib


It is important to mention that though not smoking or quitting smoking are among the best methods to prevent lung cancer, people who don’t smoke may develop lung cancer as well. Everybody should enforce prevention measures such as the following:

·         Avoiding secondhand smoke.

·         Testing homes for radon.

·         Avoiding carcinogens at work.

·         Eating fruits and vegetables.

·         Exercising regularly. 

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