Some clinical manifestations of lung cancer

The clinical manifestations of lung cancer vary depending on factors such as the pathological type of the tumor, the duration of the disease, the location and size of the tumor, the location of metastasis, and whether it is endocrine.

Early clinical manifestations of lung cancer

In the early stages of the disease, lung cancer is asymptomatic. The lung parenchyma is not rich in pain nerves, and primary lung cancer can grow to a large size without causing any symptoms. Less than 5% of patients with asymptomatic lung cancer are discovered. This lung lesion may be discovered during an unrelated complaint or a chest X-ray during a physical examination.

1. Cough is mainly caused by the cancer or its secretions irritating the tracheal and bronchial mucosa, and is usually the first symptom of lung cancer, especially in central lung cancer. When the tumor grows on the bronchial mucosa, especially in the segmental and lobar bronchi with larger diameters and stronger sensitivity, coughing may occur after reaching a certain extent. When the tumor is close to the carina, it manifests as an irritating dry cough with a small amount of white foamy sputum. Alveolar carcinoma may have a large amount of mucus sputum, which manifests as mucus-purulent sputum when secondary lung infection occurs. When the bronchial cavity is completely blocked by the tumor, coughing and sputum can be reduced or even disappear.

2. Blood in sputum or hemoptysis is a typical symptom of lung cancer. There are abundant blood vessels in the cancerous tissue. When the erosion and rupture of blood vessels or the erosion of tumors cause bronchial mucosal ulcers, it can cause repeated intermittent or continuous small amounts of hemoptysis or blood in sputum. Its diagnostic significance is greater than coughing. At this time, blood in sputum often comes from the tumor area and is mixed with a large number of tumor cells. The detection rate of sputum is very high.

3. Chest pain is a common symptom in early lung cancer. Usually, there may be irregular chest tightness, pressure or dull pain. Usually, there is no definite evidence of pleural, chest wall or mediastinal invasion. Because the lung parenchyma does not have abundant pain nerves, the cause of the pain is still unclear. It may be caused by bronchial obstruction and atelectasis, resulting in parietal pleural traction, causing reflex chest pain, or it may be caused by tumor invasion. Chest pain is not a sign of poor prognosis. Usually, chest pain can be significantly relieved after the underlying lung cancer lesions are treated.

4. Fever Fever of lung cancer is generally caused by inflammatory fever due to bronchial obstruction or compression of the lumen. Central bronchial carcinoma often causes infection fever due to the obstruction or stenosis of larger bronchus by tumors, resulting in the retention of secretions in the distal bronchus. Squamous cell carcinoma of the lung is prone to necrosis and formation of cavities, and secondary infection is also a cause of fever. The cause of fever in some patients is difficult to explain with the above reasons. Even with anti-inflammatory treatment, the fever does not subside. This is the so-called cancer fever. Non-steroidal anti-inflammatory drugs (such as indomethacin) can reduce fever or turn it into a low fever. After surgery or radiotherapy and chemotherapy to control the tumor, some patients can reduce fever.

5. Shortness of breath Lung cancer can be caused by many reasons, and is often caused by multiple factors. Obstructive pneumonia and atelectasis caused by tumors, lymphatic spread of tumors, pleural effusion, pericardial effusion and underlying lung diseases (such as emphysema, etc.) can all cause dyspnea. Dyspnea caused by uncorrectable underlying diseases, such as diffuse pleural lesions enveloping the lung tissue, or progressive tumors involving the lung parenchyma, is most effectively treated with small doses of morphine. Sedatives can also be used for terminally ill patients. Dyspnea is an extremely painful symptom for patients and their families. It is the doctor's unshirkable responsibility to minimize this pain, but in fact many patients do not receive adequate treatment.

6. Weight loss is a common symptom of lung cancer, but it is not an inevitable sign of advanced disease. As long as the tumor is active and synthesizes hormone-like active substances, such as tumor necrosis factor, cachexia can occur in patients at all stages of the disease.