Many people see a lung cancer diagnosis as a death sentence. That's understandable, since lung cancer kills more than 1.3 million people a year. But when caught early enough, lung cancer can be treatable and, often, curable. According to the National Cancer Institute, the five-year survival rate for lung cancer that hasn't metastasized, or spread, is slightly more than 50 percent, as compared to nearly 4 percent for lung cancer that's already spread to other organ systems. So pay close attention to these early -- and sometimes surprising -- signs of lung cancer, and be assertive about bringing anything suspicious to your doctor's attention.
Depression or other mood changes
Researchers have recently noted a surprising connection between first-time diagnosis of depression, anxiety, and other psychiatric symptoms and lung cancer. In a surprising number of cases, cancer patients -- particularly those with lung cancer -- discover they have a tumor after being referred for psychiatric care. One study that followed more than four million people for ten years, for example, found that when people ages 50 to 64 were referred to a psychiatrist for the first time in their lives, the overall incidence of cancer increased almost fourfold.
How it feels: Psychiatric symptoms can take many forms, from the fatigue, lethargy, and low spirits characteristic of depression to racing, panicky thoughts. Irritability, unexplained outbursts of anger, and other personality changes also can indicate psychiatric issues. As one lung cancer patient recalls, "Everything just seemed to get to me."
What causes it: The connection between anxiety, depression, and lung cancer isn't clear, except that people may be feeling generally subpar without knowing why.
What to do: If you notice personality and mood changes that are out of character, either for yourself or someone else, talk about them and search for a cause. If they seem to come out of the blue, bring them to a doctor's attention and ask if there might be a physical explanation.
Getting sick over and over again with colds, flu, bronchitis, or even pneumonia may make you wonder if your immune system is to blame. But another possible culprit for repeated illness is lung cancer. That's especially true for women who smoke.
How it feels: The symptoms are the same as they are for unrelated colds, flus, and infections. The difference is in how persistent the symptoms are: either lasting a long time or going away only to recur.
What causes it: As the cancer settles into the tissues of the lung and the bronchial tubes, it causes symptoms similar to a cold or flu. Lung cancer also makes the lungs more susceptible to illness and infection. With the body's immune system busy fighting the cancer, it's less able to defend itself against germs, resulting in more serious infections, such as bronchitis and pneumonia.
What to do: Keep close track if it seems as if you're getting sick more than usual, and bring the situation to your doctor's attention.
What Appetite Loss and Abnormal Breast Growth in Men May Mean
Loss of appetite or unexplained weight loss
If the pounds are peeling off and you haven't made lifestyle changes that would account for weight loss, or if foods you used to like begin to seem unappealing, it's important to look for an explanation.
How it feels: Some people lose interest in food and forget to eat; others find that when they sit down to eat, they feel full quickly or begin to feel nauseated when they eat too much or too fast. Still others may notice that their clothes are loose even though they hadn't been aware of eating less.
What causes it: Lung cancer can cause loss of appetite and weight loss for a number of reasons. As it becomes more of an effort to breathe (even when you're unaware that this is so), your appetite can be affected. Abdominal pain can contribute to nausea. Acute loss of appetite can occur when cancer has spread to the liver.
What to do: Keep watch on this symptom to make sure it's not caused by gastrointestinal illness, food poisoning, or some other cause such as bloating and PMS in women. If lack of appetite persists, or the needle on the scale is moving with no effort on your part, see your doctor.
Abnormal breast growth in men
Breast enlargement in men, known as gynecomastia, is an embarrassing topic, particularly with TV and movie jokes about "man boobs." But it can also be an important clue to an underlying health issue.
How it feels: Breast enlargement can be subtle or dramatic and can occur in one breast or both. The enlargement may also occur primarily around and under the nipple rather than in the surrounding breast tissue, causing a dome-like appearance.
What causes it: As tumors metabolize, they often release hormones, proteins, and other substances into the bloodstream, triggering what are known as "paraneoplastic syndromes." The resulting hormonal abnormality can lead to breast growth.
What to do: Breast enlargement is definitely something to discuss with your doctor. There's a chance it's associated with weight gain, but there are other possible explanations too that should be explored.
What Fatigue and Pain in Fingers May Mean
Another early sign of certain types of lung cancer is debilitating fatigue that's not associated with any clear cause. (In other words, you didn't just run a marathon.)
How it feels: Similar to the exhaustion you experience when you have a fever, cold, or the flu: You can't make yourself get off the couch. Cancer fatigue is tellingly persistent -- it doesn't work to "snap out of it" or rev yourself up with a cup of coffee.
What causes it: Substances released into your bloodstream by lung cancer tumors can affect oxygen levels, the health of red blood cells, adrenal gland function, and other aspects of energy production. Metastatic cancer may spread to the adrenal glands, which directly control the release of energy and the stimulus of cortisol, the fight-or-flight hormone that motivates you to act.
What to do: Because fatigue can be caused by insomnia, overwork, overexertion, and lots of other things, explore -- and deal with -- other possible causes before you call the doctor. (This will also prevent your concern from being dismissed.) Describe clearly what you can and can't do and how your condition differs from run-of-the-mill tiredness.
Thickened, painful fingertips
Clubbing or thickening of the fingertips can occur for several reasons, but the most common is lung cancer. Many people mistakenly attribute this symptom to arthritis.
How it feels: Fingertips may appear wider or raised under the nail or may feel swollen, reddened, or warm. You also might notice clumsiness and difficulty picking things up; it might feel like you're losing fine motor skills in your hands.
What causes it: Lung tumors can release cytokines and other chemicals into the bloodstream that spur bone and tissue growth at the fingertips and under the fingernails. Lack of oxygen in the blood can also restrict circulation to the fingertips.
What to do: Any unusual symptom such as thickening, swelling, or clubbing of the fingers or lack of fine motor coordination is important to bring to a doctor's attention.
What Shortness of Breath and a Persistent Cough May Mean
Shortness of breath
About 15 percent of lung cancer cases are in nonsmokers, often as a result of exposure to air pollution, secondhand smoke, or toxins such as asbestos and radon. So although shortness of breath is one of the classic symptoms of lung cancer, it tends to go unnoticed among many people until it's quite pronounced, because it's so easy to attribute to other causes.
How it feels: Like you're developing asthma or have gotten out of shape. It may feel as though it's harder to draw a deep breath, especially when exerting yourself, or you may notice a wheezy feeling in your chest.
What causes it: Lung cancer can develop in the lung sacs themselves or in the bronchial tubes leading to the lungs. Tumor growth interferes with the ability of the lungs to fully inhale and exhale air.
What to do: Ask the doctor to perform breathing tests for asthma and COPD to see if there's another potential cause. If not, ask for a chest X-ray.
Persistent cough or hoarseness
People diagnosed with lung cancer often look back and realize they've been plagued by voice changes or a recurrent cough for months or even years, but they blamed it on allergies or illness. Smokers may blame this symptom on "smoker's cough."
How it feels: One tip-off is having to clear your throat frequently; another is increased saliva production. Your voice might sound throaty or hoarse, or people might ask if you have laryngitis. The cough can be dry, like the kind that comes with allergies, or wet, such as with flu or a cold. Phlegm might be tinted orange, brown, or red with blood, or you might even spot blood in your saliva.
What causes it: When there's a blockage in bronchial tubes or lungs from a developing tumor, mucus can build up behind it. A lung tumor can also press upward and outward on the vocal cords and larynx. Tumors often have a rich blood supply, which can leak into the airway, tinting saliva and cough secretions.
What to do: Tell your doctor if you develop a chronic cough or hoarseness that doesn't go away after a few days. And if you cough or spit up blood, report this to your doctor immediately.
What Muscle Weakness and Pain in the Torso May Mean
If you feel like even carrying groceries or pushing the lawnmower is too much effort, you'll likely decide you're just tired or under the weather. But persistent muscle weakness can be one of the very earliest signs of certain types of lung cancer.
How it feels: Like everything is harder to do. Climbing stairs and household tasks may feel doubly hard or even impossible, and when you exercise you may feel like you can only manage a fraction of your usual routine.
What causes it: A specific type of muscle weakness, known as Lambert-Eaton myasthenic syndrome, occurs when lung tumors release autoantibodies that attack the muscles. Cancer cells can release chemicals that disrupt the normal activity of red blood cells, causing anemia, or lowering sodium levels and raising calcium levels in the blood. When lung cancer spreads to the brain, it can cause weakness on one side of the body.
What to do: Describe the weakness as specifically as you can, giving examples of activities that you can no longer perform easily. If you're older and the weakness could be a result of advancing age, make a clear distinction between what you're feeling now and how you've felt in the recent past.
Chest, shoulder, back, or abdominal pain
Thanks to the movies and public education campaigns about heart disease, it's almost a given to associate chest pain with a heart attack. However, it's important to consider lung cancer as a cause, particularly in people who don't have risk factors for heart disease.
How it feels: The chest or back pain triggered by tumor growth tends to take the form of a dull ache that persists over time. The ache may be in the chest or lung area, but it may also feel as if it's in the upper back, shoulder, or neck -- and it's easily confused with muscle pain. In some cases the pain is felt in the abdomen, making it easy to confuse with a digestive ailment.
What causes it: Lung cancer can cause pain through direct pressure from the tumor, or indirectly when the tumor irritates nerves traveling through the area. In some cases, chest, neck, and shoulder pain is "referred" when the brain incorrectly interprets signals from the tumor pushing on the phrenic nerve in the lungs. Small cell lung cancer can cause chest pain because it typically starts in the center of the chest in the bronchial tubes leading to the lungs and spreads rapidly, pushing on blood vessels and other organs. A specific type of tumor, known as a Pancoast tumor, forms at the top of the lungs and puts pressure on nerves, causing pain in the shoulder, in the armpit, or radiating down the arm.
What to do: Always call the doctor right away if you experience persistent unexplained chest, shoulder, back, or abdominal pain. Chest pain is a symptom in about one-fourth of people with lung cancer, yet it's most often attributed to other causes, such as heart disease.