Woman with chest pain

In many cases, lung cancer signs do not become apparent or prompt an individual to seek medical attention until the tumor reaches an advanced stage. The initial signs, if any, are typically mild and often mistakenly attributed to another, less serious condition, such as the common cold or flu. Also, there are few nerve endings that provide sensation within the lungs, making it difficult to feel changes within that area of the body. For these reasons, some patients wait a few months after symptoms develop before seeing a physician for a diagnosis.

Even so, some people may notice one or more vague warning signs that something is not quite right early on. It is important to pay close attention to these signs. In general, the earlier lung cancer is detected, the more treatment options a patient is likely to have, so it is essential to begin the diagnostic process as soon as possible.

Early-stage lung cancer signs

The initial symptoms of lung cancer usually involve the respiratory system, which includes the nose, mouth, throat, voice box, windpipe and lungs. Some patients experience:

Persistent coughing
Wheezing
Hoarseness
Shortness of breath (dyspnea)
A high-pitched whistling sound when inhaling or exhaling (stridor)
A wet cough that produces mucus, phlegm or blood
Recurrent bouts of bronchitis or pneumonia

Advanced-stage lung cancer signs

In addition to the respiratory system, advanced-stage lung cancer signs can affect other parts of the body, especially if cancerous cells have entered the bloodstream or lymphatic system and spread (metastasized) to distant tissues or organs, such as the brain, liver or bones. Advanced lung cancer may cause:

Persistent fever
Unexplained weight loss
Loss of appetite
Weakness and fatigue
Dizziness
Headaches
Bone pain
Swelling in the face, neck or arms
Jaundice (yellowing of the skin and the whites of the eyes)
Neurological symptoms, such as memory loss
Pain in the chest, shoulders or back

What does shoulder pain from lung cancer feel like?

Does lung cancer hurt? As was noted above, advanced-stage lung cancer can produce pain affecting the shoulders. This may occur for a number of different reasons. For example, if a Pancoast tumor (which develops in the top portion of the lung) starts pinching a nerve, it can cause shoulder pain. Or, if lung cancer progresses to the point where it begins spreading to distant areas of the body, there’s a chance that it can damage the muscles, which can in turn cause shoulder pain.

Considering how common shoulder pain is, many people question what shoulder pain from lung cancer feels like and how they can differentiate it from pain caused by a less serious condition (for example, arthritis or tendonitis). Unfortunately, it can be difficult to tell them apart. Like many other types of shoulder pain, lung cancer-related shoulder pain can feel like a deep ache or radiate down the arms, producing tingling and/or numbness.

If you’re experiencing shoulder pain, consider whether there’s another possible reason for the pain (for example, a recent injury). Chances are good that there’s a less serious explanation for your symptoms. However, if you can’t think of any other reason for the pain, and the pain doesn’t resolve on its own after a few weeks, you should consult with a physician to determine exactly what’s causing your symptoms.

How does lung cancer affect the skin?

Lung cancer doesn’t typically affect the skin. But in certain circumstances, lung cancer symptoms can develop on skin. For example:

If a Pancoast tumor exerts pressure on the brachial plexus nerves, it can lead to Horner syndrome, the symptoms of which may include flushed skin and an inability to sweat.
If the tumor produces a hormone that stimulates the adrenal glands to make cortisol, it can lead to the development of Cushing’s syndrome, which can in turn cause easy bruising.
If the cancer reaches an advanced stage and spreads to the liver, pancreas or bile ducts, it can cause jaundice (yellowing of the skin and eyes).

It’s important to note that certain lung cancer treatments can also affect the skin. For instance, radiation therapy can cause a painful reddening of the skin that’s similar to a sunburn. Certain immunotherapy and targeted therapy medications can also cause skin issues such as dryness, itching, flakiness and an acne-like rash.

Differences between small cell & non-small cell lung cancer symptoms

It’s common to wonder if the symptoms of lung cancer are the same across the board. For example, will a patient with small cell lung cancer have symptoms similar to one with non-small cell lung cancer? While fatigue and unexpected weight loss are more common in patients with small cell lung cancer (because it spreads more rapidly), all other symptoms are present in all types of lung cancer. The best way to know if you have non-small cell or small cell lung cancer is to be properly diagnosed.

Signs of lung cancer in women vs. men

It’s also common to question whether symptoms of lung cancer in women are the same as symptoms of lung cancer in men. Generally speaking, lung cancer produces the same symptoms in women as it does in men. However, because men are more likely to develop squamous cell carcinoma (which occurs in the lung’s airways), and women are more likely to develop adenocarcinoma (which occurs in the lung’s outer edges), men tend to notice their symptoms earlier, since those signs are more likely to affect the airways sooner.

Lung cancer diagnosis

Early-stage lung cancer can be challenging to diagnose because a lung tumor can grow quite large before it becomes visible in an imaging scan. Usually, a lung tumor cannot be detected in a routine chest X-ray until it reaches 1 centimeter in diameter. In order for a tumor to grow to that size, a minimum of 30 divisions of a single cancer cell must occur, which can take up to several years. For this reason, it is especially important to see a physician and request a lung cancer screening if any warning signs are present.

If lung cancer is suspected, a physician will typically order several imaging tests to begin the diagnostic process. For instance, a series of X-rays, CT (computed tomography) scans or MRI (magnetic resonance imaging) scans can provide the physician with a detailed visual of the patient’s lungs and thoracic cavity. The resulting images can help the physician identify lung abnormalities that may warrant further diagnostic testing. For instance, a sputum cytology, transbronchial needle aspiration or bronchoscopy may be performed to confirm a diagnosis of lung cancer and determine its type.

The role of lung cancer screening

Moffitt Cancer Center has developed a comprehensive lung cancer screening program that's one of the best in the country. It's open to patients who are considered high-risk based on national guidelines and evidence-based practices. Lung cancer screening can help physicians diagnose certain patients even before symptoms develop. The American Cancer Society recommends lung cancer screening for patients who are 55 to 74 years old, in good physical health and in line with all of the following criteria:

They currently smoke or have quit in the last 15 years.
They have a smoking history of at least 30 pack-years. (Pack-years is an equation that multiplies the number of years smoked by the number of cigarette packs smoked per day.)
If they smoke currently, they are receiving counseling to quit.
They have discussed lung cancer screening with their physician and understand the benefits, harms and limitations.
They have a facility to go to for experienced lung cancer screening and treatment.

Lung cancer screening and treatment at Moffitt Cancer Center

At Moffitt Cancer Center, we offer comprehensive low-dose CT lung cancer screening and surveillance programs for at-risk individuals. Through extensive research studies and clinical trials, such as the NCI-Sponsored National Lung Screening Trial, scientists have found that lung cancer screening programs such as ours lead to more prompt and precise diagnoses, which have long been correlated with better outcomes and quality of life.

At Moffitt, our patients benefit from our multispecialty team of specialized oncologists, pulmonologists, radiologists, pain management specialists and supportive care specialists. We also offer a tobacco treatment program to help patients and their family members quit smoking as comfortably as possible.

To request an appointment to discuss your lung cancer signs with a specialist in the Thoracic Oncology Program at Moffitt Cancer Center, please call 1-888-663-3488 or complete our new patient registration form online. No referral is needed to visit Moffitt Cancer Center. You are a top priority for a cancer center that delivers nationally ranked care in new and transformative ways, and we’ll provide rapid access to a cancer expert.