Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Symptoms of lung cancer are varied depending upon where and how widespread the
tumor is. Warning signs of lung cancer are not always present or easy to identify. A person with lung cancer may have the following kinds of symptoms:
No symptoms: In up to 25% of people who get lung cancer, the cancer is first
discovered on a routine chest X-ray or CT scan as a
solitary small mass sometimes called a coin lesion, since on a two-dimensional
X-ray or CT scan, the round tumor looks like a coin. These patients with small, single masses often report no symptoms at the time the cancer is discovered.
Symptoms related to the cancer: The growth of the cancer and invasion of lung
tissues and surrounding tissue may interfere with breathing, leading to symptoms such
as cough, shortness of breath, wheezing, chest pain, and coughing up blood
(hemoptysis). If the cancer has invaded nerves, for example, it may cause
shoulder pain that travels down the outside of the arm (called Pancoast's syndrome) or paralysis of the vocal cords leading to hoarseness. Invasion of the
esophagus may lead to difficulty swallowing (dysphagia). If a large airway is
obstructed, collapse of a portion of the lung may occur and cause infections
(abscesses, pneumonia) in
the obstructed area.
Symptoms related to metastasis: Lung cancer that has spread to the bones may
produce excruciating pain at the sites of bone involvement. Cancer that has
spread to the brain may cause a number of neurologic symptoms that may include
blurred vision, headaches, seizures, or symptoms of stroke such as
weakness or loss of sensation in parts of the body.
Lung cancers frequently are accompanied by symptoms that result from production of hormone-like substances by the tumor cells. These paraneoplastic syndromes occur most commonly with SCLC but may be seen with any tumor type. A common paraneoplastic syndrome associated with SCLC is the
production of a hormone called adrenocorticotrophic hormone (ACTH) by the
cancer cells, leading to oversecretion of the hormone cortisol by the adrenal
glands (Cushing's syndrome). The most frequent paraneoplastic syndrome seen
with NSCLC is the production of a substance similar to parathyroid hormone,
resulting in elevated levels of calcium in the bloodstream.
Nonspecific symptoms: Nonspecific symptoms seen with many cancers, including
lung cancers, include weight loss, weakness, and fatigue. Psychological symptoms
such as depression and mood changes are also common.
When should one consult a doctor?
One should consult a health-care provider if he or she develops the symptoms
associated with lung cancer, in particular, if they have