Lung Cancer Awareness Month - Symptoms to Look Out For

November is Lung Cancer Awareness Month and Austin Air is committed to making a solid effort to help combat the deadliest of all cancers. Part of the reason lung cancer is so lethal is that the symptoms rarely reveal themselves until after the disease has had a chance to progress. Therefore, it’s extremely important to know what the symptoms are and to take advantage of new advances in the diagnosis of lung cancer.

There are two major forms of lung cancer – non-small cell and small cell. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of cases. Small cell lung cancer (SCLC) is the other major type of lung cancer in the United States. Typically resulting from smoking, small cell lung cancer grows and spreads more rapidly than non-small cell lung cancer. However, it is more responsive to chemotherapy.

Patients have the best odds of surviving if they receive a diagnosis during Stages I or II, before tumors have had a chance to grow large or before the cancer has spread to other parts of the body. Most of these symptoms can seem to be the result of other health issues. Therefore, it’s helpful to be vigilant and talk to a doctor if you encounter any of the following problems, which are symptoms of both non-small cell and small cell lung cancers:

• Fatigue or weakness
• Shortness of breath
• Persistent cough which will not go away or worsens
• Chest pain which is exacerbated when breathing deeply, coughing, or laughing
• Unexplained loss of weight or appetite
• Hoarseness
• Wheezing (not related to a pre-existing respiratory condition)
• Coughing up phlegm which is rust-colored or bloody
• Infections which won’t go away or keep recurring (such as pneumonia or bronchitis)

The following symptoms can take place if the cancer has spread to other parts of the body:

• Jaundice, or yellowish coloring of the eyes and skin
• Pain in the bones, such as pain in the hips or back
• Numbness or weakness in arms or legs
• Dizziness, headaches, balance problems, or seizures which may be a signal that the cancer has spread to the brain.
• Lumps under the surface of the body from the cancer spreading through the lymph nodes or into the skin – specifically in the neck or above the collarbone.

There are also groups of symptoms which occur in tandem and are classified as syndromes, these include:

• Horner syndrome – occurs when a nerve that passes into the neck from the upper-chest is damaged by cancers in the top of the lungs. Severe shoulder pain is a typical result of this. The same tumors can also affect nerves in parts of the face and the eye which causes Horner syndrome. Signs that this is happening include:
  • Weakness, possibly drooping, of one eyelid
  • Little to no perspiration on the affected side of the face
  • A smaller pupil in the eye with the weakness/drooping

Horner syndrome may also be the result of other conditions such as spinal cord injury or stroke.

• Superior Vena Cava Syndrome – a large vein, the superior vena cava (SVC), which carries blood to the heart from the arms and head via the lymph nodes inside the chest and the upper part of the right lung may be partially blocked by tumors in this area which causes:
  • Swelling in the upper chest, neck, arms, and face
  • A bluish-red coloring in the skin in the swollen areas
  • Dizziness, headaches, and fainting
  • Trouble breathing
  • Difficulty swallowing

SVC syndrome is also associated with other maladies, including breast and testicular cancer. It can be life-threatening, making it more than just a sign of disease.

Paraneoplastic Syndromes – hormone-like substances are sometimes produced by lung cancers which can cause problems (known as paraneoplastic syndromes) with other tissues and organs, even if the cancer hasn’t spread to those areas. Bone spurs, or excess bone growth, especially in the fingers, are a paraneoplastic phenomenon which is characteristic of both small and non-small lung cancers. Otherwise, the syndromes vary between the two types of cancer.

Paraneoplastic syndromes or symptoms associated with non-small cell lung cancer include:

• Hypercalcemia (high blood calcium levels) which is characterized by nausea, vomiting, frequent urination, thirst, stomach pain, fatigue, weakness, and nervous system problems like dizziness and confusion.
• Blood clots
• Gynecomastia (breast growth in men)

Paraneoplastic syndromes or symptoms associated with small cell lung cancer include:

• SIADH (Syndrome of Inappropriate Anti-Diuretic Hormone) – this condition occurs when the cancer cells produce the hormone ADH. The kidneys begin to retain water, causing salt levels in the blood to drop which leads to cramping, muscle weakness, loss of appetite, nausea, vomiting, fatigue, confusion, and restlessness. It can lead to seizures and coma if left untreated.
• Cushing Syndrome – ACTH is another hormone which cancer cells sometimes produce, it causes cortisol to be secreted by the adrenal glands. This results in weakness, lethargy, weight gain, easy bruising, and fluid retention. It can also lead to high blood pressure and high blood sugar. Severe cases result in diabetes.

Small cell lung cancer cells can also prompt the immune system to attack parts of the nervous system which results in:

• Muscle weakness
• Vision problems
• Changes in behavior
• Sensory changes
• Lambert-Eaton Syndrome – weakness in hip muscles which can make it difficult to stand from a sitting position. Later, the shoulder muscles may also become weak.
• Paraneoplastic Cerebellar Degeneration – rarely seen but results in unsteadiness in leg and arm movement, and trouble swallowing or speaking.

In all likelihood, the presence of these symptoms or syndromes will be the result of another ailment but seek medical attention if they occur. While that may seem like an obvious step for an otherwise healthy adult who suddenly begins to have seizures, persistent back pain may not seem urgent. A few days of experiencing these symptoms shouldn’t trigger major anxiety but if any problem remains for an extended period of time please seek professional advice. Some of the symptoms and syndromes outlined above are serious enough to take your life before the cancer can.

In our next installment, we’ll explain more about the screening process in people without symptoms – and how it varies from testing in people who already show symptoms.