Early symptoms of lung cancer

Written by Gong Chun
Oncology
Updated on September 13, 2024
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Early-stage lung cancer, especially peripheral lung cancer, often has no symptoms and is mostly found during chest X-rays or CT scans. The clinical symptoms of lung cancer are closely related to the location, size, pathological type of the tumor, whether it compresses or invades adjacent organs, and whether there is metastasis. The symptoms of lung cancer generally include: First, some symptoms of the primary tumor growing locally, including cough, hemoptysis, difficulty breathing, and chest pain. When the tumor grows inside a larger bronchus, it might cause some irritative coughing. Second, as the tumor continues to grow and affects the drainage of the bronchi, it may lead to secondary lung infections, presenting with symptoms such as cough and purulent sputum. Third, there might be bloody sputum streaked with blood or intermittent minor hemoptysis, though significant hemoptysis is very rare.

Other Voices

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Written by An Yong Peng
Pulmonology
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Is coughing severe in the early stages of lung cancer?

Patients with lung cancer in the early stages may experience severe coughing, mild coughing, or no coughing symptoms at all. Many early-stage lung cancer patients have lesions located near the periphery of the lungs that do not involve the airways or other significant structures, typically resulting in no clinical symptoms. By the time clinical symptoms appear, the patient may already be in the middle or late stages of lung cancer. Additionally, it is important to note that some patients with early-stage lung cancer may also experience coughing, which can range from severe to mild, and may include coughing up blood. Such symptoms are often seen in early-stage central lung cancer, which frequently presents with cough and blood in the sputum. Therefore, older patients with a long history of smoking who suddenly develop a cough or start coughing up blood should be highly vigilant and likely need to undergo chest CT scans, bronchoscopy, and other related examinations for evaluation.

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Written by An Yong Peng
Pulmonology
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Is the appetite good in the early stages of lung cancer?

In the early stages of lung cancer, generally, there is no obvious impact on the appetite. Most early-stage lung cancers do not show clinical symptoms. However, some patients may experience coughs or blood-streaked sputum if the tumor grows along the inner wall of the airway, stimulating the respiratory tract. Nevertheless, early-stage lung cancer typically does not metastasize or spread to the digestive tract. Thus, early-stage lung cancer usually does not affect the patient's appetite, and the patient's appetite generally remains unaffected. However, it is crucial to diagnose early-stage lung cancer because surgical removal at this stage can often achieve good results. Once it progresses to mid or late stages, the outcomes are usually poor, and the survival period is typically short. Therefore, it is advocated that people at high risk for lung cancer undergo regular chest CT screenings to check for early-stage lung cancer.

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Written by An Yong Peng
Pulmonology
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Can early-stage lung cancer cause shoulder pain?

In the early stages of lung cancer, it generally does not cause shoulder pain. Early-stage lung cancer often does not involve critical structures and typically does not produce noticeable clinical symptoms. However, a small number of central lung cancers may cause symptoms related to coughing. Moreover, shoulder pain can occur in cases of lung cancer, often seen in superior sulcus tumors. A superior sulcus tumor, also known as a Pancoast tumor, is a tumor located at the top of the lung. As the tumor grows, it may compress the brachial plexus nerves, leading to symptoms such as shoulder pain and throat pain. It can also cause symptoms like enophthalmos (sunken eyeball) and pupil constriction. Therefore, when encountering these signs clinically, it is necessary to consider the possibility of a superior sulcus tumor and conduct examinations like a chest CT scan for evaluation.

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Written by Gong Chun
Oncology
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What is the treatment for lung cancer?

Treatment for lung cancer should be based on the pathological staging, the pathology type, the biological behavior of the lung cancer, and individualization, taking into account the patient's cardiopulmonary function and overall systemic condition to develop a personalized treatment plan. For non-small cell lung cancer and small cell lung cancer, the treatment approaches differ significantly. Therefore, it is advisable for patients to seek treatment at specialized hospitals, under the guidance of oncology specialists. Generally, treatment options for non-small cell lung cancer include surgical resection, adjunctive chemoradiation, neoadjuvant chemoradiation, targeted therapy, and immunotherapy. For small cell lung cancer, a comprehensive treatment plan combining chemoradiation, along with prophylactic cranial irradiation and other aggressive treatments, is recommended. Each individual's situation might differ, so it is important to focus on a personalized comprehensive treatment plan rather than a one-size-fits-all approach.

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Written by Li Ying
Pulmonology
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Is hemoptysis lung cancer?

Coughing up blood is not necessarily lung cancer. Among respiratory diseases, the three most common causes of coughing up blood are, first, bronchiectasis; second, pneumonia and lung abscess; and third, lung cancer. So how can we determine the cause? The best, simplest, and fastest method is to go to the hospital for a lung CT scan as soon as coughing up blood occurs. If the lung CT shows bronchiectasis, then bronchiectasis should be considered; if it shows an infiltrative lesion, then pneumonia should be considered; if it shows a tumor, then lung cancer should be considered at that time. However, there is also a scenario where blood is coughed up, but the lung CT is completely normal. What should be done then? This situation might be due to pharyngitis. Sometimes, severe coughing from pharyngitis can cause bleeding of the mucous membranes in the throat. In this case, there’s no need for excessive worry, as it may be caused by factors involving the throat. Cough gently, and if there’s no blood when coughing lightly, it’s likely not serious. However, if there's still blood in the sputum even when coughing lightly, it is recommended to undergo a bronchoscopy to check for tuberculosis or cancer in the bronchi.