It is widely believed that a cough is the primary sign of lung cancer, or that everyone diagnosed with lung cancer would experience shortness of breath. However, that’s not always the case. In fact, there are several surprising signs and symptoms that can indicate lung cancer.
Facts about Lung Cancer
Over 225,000 people in the United States will develop lung cancer in the coming year. Even though lung cancer cases have decreased for the past ten years, lung cancer still accounts for about 13% of all cancers diagnosed in the United States.
Smoking is one of the main causes of lung cancer:
- Smoking causes 80% of the lung cancer deaths in women and 90% in men.
- Men that smoke are 23 times more likely to get lung cancer.
- Female smokers are 13 times more prone to develop lung cancer.
But non-smokers get lung cancer too — risk factors include radon gas and worked-related exposure to carcinogens. Non-smokers who are exposed to second-hand smoke have a 20-30% greater risk for developing lung cancer.
Lung cancer is most common in people over 65. However, younger adults can and do develop lung cancer, but less than 2% of patients are below 35.
Expected Symptoms of Lung Cancer
Lung cancer produces symptoms that most people would expect. These symptoms are tied to the basic functions of our lungs. These symptoms include:
- Coughing. Coughing that doesn’t go away or gets worse.
- Shortness of breath. Feeling out of breath, tightness in the chest, feeling like you can’t breathe, or feeling you can’t get enough air.
- Coughing up blood, phlegm, or mucus. Coughing up blood-tinged or rust-colored phlegm or mucus.
- Chest pain. Pain that gets worse with laughing, coughing, or deep breathing.
- Wheezing. Wheezing is that high-pitched whistling sound that happens when exhaling.
Unexpected Signs and Symptoms of Lung Cancer
What sort of symptoms would be considered unexpected, shocking, or surprising? These signs and symptoms don’t appear to be related to our lungs. The general public would not expect these indicators or signals to be a warning of lung cancer.
- Arm/shoulder pain or eye problems. One kind of lung cancer (called a Pancoast tumor) develops in the lung’s upper part. Instead of affecting the lungs, these tumors may spread to the ribs, the vertebrae of your spine, or the nerves or blood vessels. These tumors cause pain in your shoulder blade, upper back, or arms. They might cause numbness or tingling in your hands too. The Pancoast tumors that cause arm/shoulder pain can also cause eye problems. Patients may realize that the pupil of one eye is smaller, that eyelid droops, and less perspiration on that side of your face. This “set” of eye symptoms is called Horner Syndrome.
- Hoarseness or change in voice. Some people get hoarse — your voice may sound strained or raspy or sound lower in tone or softer in volume. A tumor in the lung can press on the nerve that controls the vocal cords. Hoarseness is caused by many other conditions, too, like a cold or laryngitis.
- Balance problems. Feeling unsteady or losing your balance can be a result of lung cancer. A tumor may be located near the superior vena cava (SVC), a large vein that takes blood from your head and arms back to the heart. As the tumor grows, it can cause the blood to back up in this vein and cause dizziness or balance loss. Anemia, common in lung cancer, can cause balance problems too.
- Weight. Patients with lung cancer can gain or lose weight. The tumors of small-cell lung cancer sometimes cause the body to make a hormone called ACTH. ACTH, in turn, causes the body to make cortisol. Too much cortisol causes fluid retention and weight gain. Other patients, however, lose weight — usually caused by the higher calcium levels that cause loss of appetite.
- Blood clots. People with lung cancer are more likely to develop blood clots in your legs, arms, or lungs. Researchers believe that cancer increases inflammation in the body. The inflammation, in turn, causes blood clots.
- Bone pain. Some people have bone pain or feel weak and achy. Sometimes, it’s difficult to tell the difference between bone and muscle pain. If your pain gets worse when moving, at night, or when lying on your back, it’s probably bone pain. Lung cancer can spread to the bones, causing bone pain in the spine/back, pelvis, or large bones of the arms and legs.
- Clubbed fingers – fatter fingers. The ends of the fingers appear “fatter.” The skin next to the fingernail may look shiny. The fingernail begins to curve downward like a spoon. An astonishing 80% of people with clubbed fingers have lung cancer.
- Digestive problems. Between 10-20% of people with lung cancer get high levels of calcium in their blood, a condition called hypercalcemia. Too much calcium in the blood may cause digestive problems, like tummy aches, constipation, or nausea.
- Extreme thirst and frequent urination. The higher levels of calcium in your blood (hypercalcemia) that cause digestive problems may also cause extreme thirst and frequent urination.
- Fatigue or feeling tired. Because lung cancer causes the lungs to not function as well, patients can become anemic. Cancer feeds off the body’s nutrients, robbing the body of energy to get through everyday chores.
- Headaches. Headaches can be caused by a tumor near the superior vena cava (the large vein that transports blood from the head and arms back to the heart). Backed up blood in this vein can make your head pound or even pass out. High blood calcium levels, seen in up to 20% of lung cancers, also causes headaches.
- Heart problems. High calcium levels and anemia can cause heart problems — usually either a rapid heartbeat or irregular heartbeat. High calcium levels can cause extremely serious heart problems, including a heart attack or going into a coma. Severely anemic patients may experience chest pain and shortness of breath.
- Puffy face, neck, or arms. Once again, a tumor, pressing on the large vein that carries blood from the head and arms, can produce symptoms. The blood that would have gone back to your lungs gets backed up, with no place to go — producing swelling in the face, neck, and/or arms. Your chest might develop a purplish tint too.
- Quitting smoking is suddenly easy. Some people who are suddenly able to stop smoking may already have lung cancer. Experts believe this is because the cancerous cells in the lungs may interfere with nicotine addiction.
- Swollen breasts in men. A less common kind of lung cancer, called large-cell, may interfere with a man’s hormone levels, causing swelling and tenderness in a man’s breasts.
- Anxiety, depression, or dementia. Experts aren’t sure why, but people with lung cancer are more likely to experience mental health issues that require treatment. Mental health issues combined with other symptoms are concerning.
While none of these signs and symptoms definitely mean lung cancer, having several of these symptoms is concerning. It’s time to schedule a checkup with your primary care physician to discuss your symptoms.