Symptoms of lung cancer transformation in chronic obstructive pulmonary disease

Written by Yang Feng
Pulmonology
Updated on January 21, 2025
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Lung cancer is a complication of chronic obstructive pulmonary disease (COPD), but it is relatively less common for COPD patients to also have lung cancer. Regular health check-ups, including annual lung CT scans, can help identify the possibility of cancerous changes at an early stage. In the early stages of lung cancer, patients generally do not show obvious clinical symptoms. As the disease progresses, symptoms such as coughing up blood, weight loss, fatigue, and night sweats may occur. However, since the clinical symptoms of lung cancer are similar to other lung diseases, there are no typical clinical features, and imaging studies are needed for preliminary screening.

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Staging of Lung Cancer

The staging of lung cancer is of great clinical significance for the selection of clinical treatment plans and the prediction of prognosis. According to the International Association for the Study of Lung Cancer and the World Health Organization, lung cancer is staged based on the size of the primary tumor (T stage), the condition of tumor lymph node metastasis (N stage), and the presence of distant metastases (M stage). Lung cancer is classified according to these criteria, which are used internationally. Currently, there are UICC staging and AJCC staging, which are two different systems.

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How to detect early symptoms of lung cancer?

So, the early symptoms of lung cancer often include a cough, hemoptysis, difficulty breathing, and chest pain. However, these symptoms, particularly the irritating cough, typically appear after the tumor has grown in the larger bronchi; this is often mistaken for a cough following a cold, leading to misdiagnosis or delayed treatment. Therefore, if this type of irritating cough occurs, it is essential to seek medical attention promptly and to undergo chest X-ray or CT scan. Second, as the tumor continues to grow and affects the drainage of the bronchus, secondary lung infections may occur, often characterized by coughing up pus-like sputum, and an increase in the amount of sputum, which should also be noted. Third, a very common symptom is the presence of blood in the sputum, or streaks of blood, or intermittent minor hemoptysis, which must be taken seriously.

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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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Does lung cancer cause a dry cough and a feeling of stuffiness?

Lung cancer can present symptoms of chest tightness along with dry cough, or it may simply manifest as dry cough alone. Some early-stage lung cancers might only involve dry cough without other symptoms like chest tightness or breathing difficulties. However, for patients with advanced lung cancer, in addition to dry cough, symptoms may include chest tightness and breathing difficulties. Advanced lung cancer can compress the patient's major airways, leading to narrowing of these airways, and thus cause symptoms such as dry cough and chest tightness. In advanced stages, lung cancer may also be accompanied by a significant accumulation of pleural effusion. In such cases, patients might experience chest tightness and breathing difficulties along with dry cough. Therefore, lung cancer can either solely manifest as dry cough or may also be accompanied by symptoms of chest tightness, particularly in advanced stages, where it is relatively common to have chest tightness along with dry cough.

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Is lung cancer contagious?

The occurrence of lung cancer is associated with smoking, air pollution, and working in environments such as coal mining. However, lung cancer is not contagious. Therefore, in clinical settings, family members of patients often ask doctors whether lung cancer can be transmitted through the respiratory tract. It can be assured that lung cancer is not contagious; only communicable diseases like tuberculosis can be spread this way.