What are the signs and symptoms of lung cancer?

Most lung cancers do not cause symptoms until they have spread, but you should report any of the following problems to a doctor right away. Often these problems are caused by something other than cancer. But if lung cancer is found, getting treatment right away might mean treatment would work better. The most common symptoms of lung cancer are:

• A cough that does not go away
• Chest pain, often made worse by deep breathing, coughing, or laughing
• Hoarseness
• Weight loss and loss of appetite
• Coughing up blood or rust-colored sputum (spit or phlegm)
• Shortness of breath
• Feeling tired or weak
• Infections such as bronchitis and pneumonia that keep coming back
• New onset of wheezing

We usually see pulmonary symptoms as the presenting complaint of a patient with lung cancer. Cough,infection and bleeding are seen first. With the spread of the disease we see weakness, swelling, bone pain, and at times neurologic symptoms. 

Symptoms of lung cancer include a persistent cough, shortness of breath, recurring respiratory tract infections, or a recurring cold. Many patients first see their doctor about a cold, cough, or possible pneumonia. More advanced symptoms may include blood mixed in sputum and unrelenting chest pain.

Many symptoms of lung cancer unfortunately are similar to those of upper respiratory infections, including bronchitis or pneumonia. These include cough, dyspnea (shortness of breath), chest pain, and occasionally blood-tinged sputum. Many patients with these symptoms are initially treated with a course of antibiotics for presumed bronchitis. Others who have a history of chronic obstructive pulmonary disease (COPD) may be treated with bronchodilators and/or steroids ("inhalers") by their primary doctor or pulmonologist. The vast majority of patients will have their symptoms resolve after these medications, since most of the time the source will be infection or lung inflammation.

However, symptoms that don't resolve always require further investigation. Unexplained weight loss, a cough that persists for more than a couple of weeks, or hemoptysis (coughing up blood) should always prompt medical attention. Still other patients are found to have lesions on chest x-rays or computerized tomography (CT) of the chest obtained for other purposes and are asymptomatic (without symptoms) at the time. This group of patients tends to fare better than those who already have symptoms.