September 10, 2020

Lung Cancer: Symptoms and Diagnosis

Lung cancer is the leading cause of cancer deaths worldwide in both men and women. It is established that cigarette smoking is the most significant risk factor for lung cancer, and this includes second-hand smoking wherein you breathe in other peoples' smoke. Bear in mind other factors play a minor role in causing lung cancer, like exposure to radon gas, family or personal history of cancer, previous treatment, and diet.

See the separate article, Risk Factors, Genetics and Types of Lung Cancer for more details.

Possible early complaints of lung cancer

This article discusses symptoms which may suggest lung cancer.

Different people have different symptoms for lung cancer. So it’s important to report unusual physical feelings to your doctor. Often, these unusual feelings are attributed to other causes, such as bronchitis. But a doctor should check anything that is unusual or worrisome.

Some people have symptoms related to the lungs. Others whose lung cancer has spread to other parts of the body (metastasized) have symptoms specific to that part of the body. Some people just have general symptoms of not feeling well (this is usually waved off as vague or non-specific symptoms).

Most people with lung cancer don't have any symptoms at all until the cancer is advanced. Some other people may have the symptoms early on. The signs and symptoms of lung cancer can take years to develop and they may not appear until the disease is very well advanced.

Symptoms of lung cancer

Symptoms of lung cancer that are in the chest:
  • Coughing, especially if it persists or becomes intense, and doesn't go away
  • Pain in the chest, shoulder, or back unrelated to pain from coughing
  • A change in color or volume of sputum
  • Shortness of breath
  • Changes in the voice or being hoarse
  • Harsh sounds with each breath (stridor or wheezes)
  • Recurrent lung problems, such as bronchitis or pneumonia
  • Coughing up phlegm or mucus, especially if it is tinged with blood
  • Coughing up blood
If the original lung cancer has spread, a person may feel symptoms in other places in the body. Common places for lung cancer to spread include other parts of the lungs, lymph nodes, bones, brain, liver, and adrenal glands.

Symptoms of lung cancer that may occur elsewhere in the body:
  • Loss of appetite or unexplained weight loss
  • Muscle wasting (also known as cachexia) with no other known cause
  • Fatigue
  • Headaches, bone or joint pain
  • Bone fractures not related to accidental injury
  • Neurological symptoms, such as unsteady gait or memory loss
  • Neck or facial swelling
  • General weakness (feeling very tired all the time)
  • Bleeding
  • Blood clots
Other changes that can sometimes occur with lung cancer may include repeated bouts of pneumonia and swollen or enlarged lymph nodes (glands) inside the chest in the area between the lungs.

These symptoms can happen with other illnesses, too. If you have some of these symptoms, talk to your doctor, who can help find the cause.

Diagnosing Lung Cancer

The recommended screening test for lung cancer is low-dose computed tomography (also called a low-dose CT scan, or LDCT). The U.S. Preventive Services Task Force recommends yearly lung cancer screening with LDCT for people who—
  • Have a history of heavy smoking, and
  • Smoke now or have quit within the past 15 years, and
  • Are between 55 and 80 years old.
Heavy smoking means a smoking history of 30 pack years or more. A pack year is smoking an average of one pack of cigarettes per day for one year. For example, a person could have a 30 pack-year history by smoking one pack a day for 30 years or two packs a day for 15 years.

If lung cancer is suspected as a result of a screening procedure (CT, MRI or PET scan), a small piece of tissue from the lung must be examined under a microscope to look for cancer cells. Called a biopsy, this procedure can be performed in different ways. In some cases, the doctor passes a needle through the skin into the lungs to remove a small piece of tissue; this procedure is often called a needle biopsy.

MRI scanner machine
Lung cancer may be suspected following screening with an MRI machine
In other cases, a biopsy may be done during a bronchoscopy. With the patient under sedation, the doctor inserts a small tube through the mouth or nose and into the lungs. The tube, which has a light, small camera and a surgical instrument on the end, allows the doctor to see inside the lung and remove a small tissue sample.

If cancer cells are found in the tissue sample, a genetic test may be performed. The information obtained from the test can help doctors choose the best treatment.

Pathologists (doctors who identify diseases by studying cells and tissues under a microscope) and geneticists (scientists with special training in the study of genes) can give your doctor the information he or she needs to tailor a treatment that will be most effective. These specialists can determine the distinct characteristics of each lung cancer: the tumor type (NSCLC or SCLC, for example); how far it has advanced (its stage); and the mutations (gene changes) that cause or “drive” the cancer.

1). Centers for Disease Control: Lung Cancer - Basic information. Accessed 22.08.2017. Available here:
2). Lung Cancer 101: What is lung cancer?. Accessed 22.08.2017. Available here:

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