Early Signs of Lung Cancer You Need to Know - Verywell Health
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Many people with lung cancer show no signs or symptoms at the early stages of cancer development. But by looking back at what symptoms people diagnosed with lung cancer have reported, we can gain insight into some early warning signs people at high risk for lung cancer can look out for.
Early-stage lung cancer is more survivable than advanced cancers that have spread (metastasized) to other parts of the body. But because the lungs have very few nerve endings, they don't feel pain or other sensations, so early signs of lung cancer are hard to come by.
Depending on the type of lung cancer developing, early signs of lung cancer might include referred pain (pain perceived in an area of the body other than the lungs, such as the shoulder), chronic cough, breathing issues, and weight loss. Some of these symptoms are dependent on the type of cancer, and not every early case of lung cancer has all of these symptoms.
Most often, symptoms of lung cancer only show up as the tumor becomes more advanced. Even relatively large tumors don't always cause pain or discomfort.
Lung Cancer Statistics
Lung cancer is the second most common type of cancer for people of any sex in the United States, but it's the number one reason that people die from cancer.
Sadly, the fact that early lung cancer symptoms are difficult to detect means that by the time about half the people with it are diagnosed, it has already spread to other organs. This makes it very difficult to treat.
Detecting lung cancer early by noting early warning signs and symptoms can save lives, especially if someone is at high risk for developing this type of cancer. People at high risk include smokers and those exposed to secondhand smoke. Tobacco smoke is responsible for about 90% of lung cancers. Still, lung cancer can affect anyone.
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Early lung cancer symptoms also are relatively common in many other illnesses. This makes it even harder to detect and makes symptoms easier to shrug off if they do develop.
But it also may mean that what you're experiencing is not lung cancer after all. To be sure of the cause, talk to your doctor if you're at high risk for lung cancer and have some of the symptoms.
This article will cover the symptoms that can serve as early warning signs for lung cancer, symptoms of more advanced lung cancers, and when to see a doctor about your symptoms.
Persistent Cough
About half of people diagnosed with lung cancer have a persistent cough. A cough related to lung cancer will likely develop on its own (not after an illness) and continue to worsen.
A persistent, chronic cough is one that does not go away and lasts at least eight weeks. It can be a dry cough or it can bring up phlegm. It may keep you up at night, interfering with sleep. It may even be painful.
Lung cancer is not the most common reason someone will develop a cough, even a persistent cough. Coughing is the body's natural reaction to irritating particles in the throat or lungs.
Acute coughs are often associated with infectious diseases. Chronic coughs are likely caused by irritants, including stomach acids, pollution, or smoke. They can also be related to other conditions, like asthma.
Smoker's cough is a chronic cough related to smoking cigarettes. Smoking can lead to lung cancer, but a smoker's cough isn't always a sign of lung cancer. Smoker's cough is caused when the tobacco smoke kills the hairs (cilia) lining your airways that usually remove mucus.
Smoking also causes cough and breathing issues in a group of conditions called chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema. COPD will keep getting worse and can ultimately be fatal on its own.
COPD can increase your risk of developing lung cancer by as much as five times, but the cough associated with COPD isn't caused by lung cancer. If you quit smoking and the cough doesn't clear up in a month, get it checked out.
Causes of Coughs
Coughs are a regular part of life, and the vast majority of the time they are not due to lung cancer. Ninety percent of all cases of chronic cough are caused by postnasal drip, asthma, and gastroesophageal reflux disease (GERD).
While a persistent cough that appears out of nowhere is important to get checked out, there are a lot of reasons other than lung cancer that might be causing it.
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Chest Pain
Unexplained chest pain can be an early sign of lung cancer. This pain won't have a specific cause, such as an easily identifiable injury preceding the pain. If you can't remember how or why it started and it's progressing and getting worse, you should probably get the pain checked out.
Pain may increase when laughing, coughing, or breathing deeply—a condition called pleurisy. While the lungs themselves don't have nerves, this pain can be caused in multiple ways, including:
- A tumor pushes on a nerve in the tissues lining and surrounding the lungs or in the back or ribs.
- Cancer spreads to the ribs or bones of the spine.
- Excessive coughing leads to muscle pain or broken ribs.
This pain can be in the chest but also might be felt as shoulder pain or back pain. Chest pain can be a symptom of many other conditions, including heart attack or even GERD, but you should get it checked out.
Shortness of Breath
Sudden shortness of breath is a symptom that might indicate the early stages of lung cancer. Shortness of breath is when you start breathing heavier or quicker in an attempt to get enough air into your lungs. You're huffing and puffing like you just sprinted to catch the bus. Your chest may feel tight.
This loss of breath can come on suddenly, during everyday activities, or be more of a persistent issue during times when you're exerting yourself. Shortness of breath can develop naturally based on old age or a loss of fitness, or it can be due to a panic attack or hyperventilation.
But about 85% of the time, shortness of breath is a sign of something more worrisome with the heart or lungs. Especially in smokers, it may signal COPD or lung cancer. It may also be a sign of heart disease, so get it checked out even if you're not at high risk of lung cancer.
Shortness of breath is often one of the first signs of non-small cell lung cancers like adenocarcinomas, the most common type of lung cancer.
Unintentional Weight Loss
The early stages of cancer may lead to a loss of appetite and unexplained weight loss. If you're not changing your diet or exercise routine and are losing weight, you may want to talk to a medical professional.
Advanced cancer is associated with inflammation and the release of cytokines (proteins that regulate inflammation) that may produce a loss of appetite and weight loss. Tumors high in the chest can also push on the esophagus (food pipe), making it hard to swallow and difficult to eat.
Hoarseness or Wheezing
Lung cancer may change how air moves through your windpipe and vocal cords, leading to changes in your voice, including an increased huskiness or hoarseness. This hoarseness can be caused by coughing directly or by the tumor impacting the vocal cords in some way.
It can also cause wheezing, making it feel like you're breathing through a straw, with an audible sound.
Coughing Up Blood
As lung cancer starts to impact the lung tissues, you may start to cough up blood. The technical term for coughing up blood is hemoptysis. The blood can look rust-colored, might be clotted, or may look like pink or red streaks in the mucus.
Call the doctor immediately if you're coughing up more than half a cup (100 milliliters) of bloody mucus, as this is a symptom that can rapidly get worse. If you've been coughing up blood for more than a week, you should also get that checked out.
Less Common Symptoms
Other than the early warning signs and symptoms of lung cancer listed above, there are a few other less common symptoms that might crop up during the early stages of lung cancer, including:
- Feeling weak and exhausted
- Having repeated respiratory infections, including bronchitis and pneumonia
Tumors in the upper right part of the lung can press on the blood vessels around the heart and cause symptoms. This is called superior vena cava syndrome because blood backs up in the large vein leading to the heart—the superior vena cava.
When this happens, blood gets trapped in the upper body, including the face, neck, arms, and upper chest. Symptoms of superior vena cava syndrome include:
- Bluish tint to the upper body
- Swelling of the upper body
- Headaches, dizziness, and fainting
Another possible early sign of lung cancer is the development of a suite of symptoms due to paraneoplastic syndromes. These conditions arise when the lung cancer tumor puts out proteins that harm other parts of the body.
Paraneoplastic syndromes are more often associated with small cell lung cancer, but can happen with either type. The multiple forms of paraneoplastic syndrome, which are based on how the tumor is impacting the body and what organs are involved, are:
- Syndrome of inappropriate antidiuretic hormone (SIADH) causes the kidney to hold on to too much water. Symptoms include fatigue, appetite loss, muscle cramps and weakness, digestive issues, feeling restless, and confusion.
- Cushing syndrome causes the adrenal glands to make the stress hormone cortisol. Symptoms include weight gain, unexplained bruises, sleepiness, weakness, swelling from fluid retention, high blood pressure, diabetes, and high blood sugar levels.
- Lambert-Eaton syndrome is when the immune system attacks the nervous system, weakening select muscles. Symptoms include difficulty getting up from sitting.
- Paraneoplastic cerebellar degeneration is when the immune system attacks the nervous system. Symptoms include unsteady movements, loss of balance, difficulty swallowing or speaking.
- Hypercalcemia arises from too much calcium in the blood. Symptoms include having to urinate a lot, being very thirsty, digestive issues, neurological issues.
More Advanced Symptoms
As lung cancer advances, symptoms will become more prominent. You'll likely develop these symptoms after the signs above have made themselves known.
Advanced lung cancer symptoms include:
- Pain in the bones of the back or hips, possible broken bones
- Swollen lymph nodes in the neck or collarbone region
- Headache, dizziness, balance issues, seizures, weakness in the limbs, and other nervous system problems
- Yellow eyes or skin (jaundice) and other signs of liver problems
- Blood clots
Shoulder pain that radiates down to the pinky finger may be a sign of cancers in the upper lungs, which are more likely to be non-small cell lung cancer and are sometimes called Pancoast tumors. These cancers have unique effects on the nerves of the face, causing a set of strange symptoms called Horner syndrome.
Horner syndrome symptoms include:
- Drooping eyelid
- One small pupil
- Sweating on only one side of the face
When to See a Doctor
If you're at high risk for lung cancer and have any of the symptoms described above, it's best to get checked out by a doctor or other health professional. Coughing up blood or having trouble breathing are two major signs to watch for.
High-risk patients, especially current smokers or those who have smoked more than 30 pack-years, are potential candidates for regular lung cancer screenings. Thirty pack-years is equivalent to smoking two packs a day for 15 years or one pack a day for 30 years, or similar multiples. These screenings would use imaging techniques like computed tomography (CT) scans to determine if your lungs show signs of cancer.
You may want to talk to a health professional about this option if you have exposure to toxins like cigarette smoke that cause lung cancer, have an inherited disease that is linked to increased risk of lung cancer, or if many people in your family have developed lung cancer.
Studies suggest that getting these screenings yearly may help lower the risk of death from lung cancer in high-risk individuals. They also can detect other problems that are not cancer but require tests and surgeries.
A health professional can determine if you're a good candidate for screening and walk you through the pros and cons of getting it done.
Frequently Asked Questions
What causes lung cancer?
Lung cancer develops when the cells of the lungs start to change, or mutate. Cells begin growing out of control, building up too quickly before others can die off and preventing new, healthy cells from forming. The built-up cells form tumors.
This process occurs when there are breaks in certain parts of the genetic code, which tells the cells what to do and how to act. These breaks can happen for several reasons, such as from inheriting an already broken code or from exposure to environmental toxins.
What does lung cancer feel like?
When people get a lung cancer diagnosis, they'll likely have some minor symptoms, including cough, coughing up blood, and trouble breathing. As cancer progresses, they'll develop pain, potentially in the chest, back, or shoulder, then elsewhere as the cancer spreads.
It will become harder to breathe as the tumor overtakes the lungs. Having cancer is also extremely exhausting. Since people with lung cancer may lose their appetite, they may have very little energy and typically lose weight. Treatments like chemotherapy and radiation may increase some of these symptoms.
How long can you live with stage 4 lung cancer?
The five-year survival rate for lung cancer is not good. According to the National Cancer Institute's SEER (Surveillance, Epidemiology, and End Results) database, only 21.7% of people diagnosed with lung cancer are alive five years later. Survival rates are better in cancers that are caught early, but more than half (56%) are not diagnosed until the cancer spreads to the rest of the body.
| Lung cancer survival rates | |||
|---|---|---|---|
| Stage | Spread | The percent of lung cancers diagnosed at this stage | The five-year survival rate of lung cancers diagnosed at this stage |
| Localized | Cancer hasn't spread beyond the tissue or organ it originated in. | 18% | 59.8% |
| Regional | Cancer has spread to nearby organs or lymph nodes. | 22% | 32.9% |
| Distant | Cancer has spread to far areas of the body. | 56% | 6.3% |
| Unknown | Unknown | 4% | 9.6% |
How can I avoid lung cancer?
If you're worried about lung cancer, the best thing you can do right now is stop smoking. Smoking causes about 90% of lung cancer cases. The toxins in cigarettes can cause breaks in the genetic code and lead to lung cancer. The sooner you quit, the healthier your lungs will be.
Other toxins that can lead to lung cancer include radon, asbestos, uranium, arsenic, cadmium, chromium, nickel, and petroleum products. Make sure to wear adequate personal protective equipment when you're working with these chemicals.
Pollution is the other major cause of lung cancer. Living in areas with high pollution, like exhaust smoke, will increase your risk of developing lung cancer.
A Word From Verywell
If you think you have some of these symptoms and are at high risk for lung cancer, talk to your doctor about getting examined. Many of the symptoms of lung cancer can mock other illnesses and, therefore, can be difficult to diagnose. Very often, though, they'll have a cause that's not lung cancer. Until you know more and can get tested, try not to worry.
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