Symptoms of lung cancer

The clinical manifestations of lung cancer are closely related to the location, size, type, development stage, and presence or absence of complications or metastasis of the tumor. Generally, central lung cancer presents symptoms earlier and more obviously than peripheral lung cancer. Most patients have symptoms when they seek medical treatment, and only 5% are asymptomatic. Common clinical symptoms and signs include the following aspects.

1. Symptoms and signs caused by the primary cancer include cough, hemoptysis, chest tightness and breathlessness, wheezing, fever, and sore throat and cachexia. Cough is the most common early symptom, which is caused by the tumor irritating the bronchial mucosa or carina. It is often a piercing dry cough, sometimes with a high-pitched metallic sound. Mucus and purulent sputum may occur during concurrent infection, and a large amount of mucus and sputum may be coughed up in alveolar carcinoma. Since the tumor tissue is rich in blood vessels, it often causes continuous or intermittent blood in the sputum. If it erodes large blood vessels, it may cause massive hemoptysis. The growth of central lung cancer causes bronchial stenosis or obstruction, that is, chest tightness and breathlessness occur. Tumor spread or metastasis leads to a large amount of pleural effusion or pericardial effusion, which can also cause progressive chest tightness and worsening breathlessness. Wheezing is caused by partial bronchial obstruction, often with localized wheezing. When the tumor partially or completely blocks the bronchus, it is easy to cause obstructive pneumonia or lung abscess, and bacterial infection fever occurs. Tumor necrosis can also cause fever. When lung cancer develops to the late stage, weight loss and cachexia may occur due to physical consumption and intake disorders caused by the tumor.

2. Symptoms and signs caused by local tumor expansion include chest pain, dysphagia, hoarseness, superior vena cava obstruction syndrome, and symptoms caused by compression of superior pulmonary sulcus tumor. Chest pain is caused by tumor invasion of the pleura, ribs, chest wall, or intercostal meridians. When the tumor compresses or invades the esophagus, it can cause dysphagia, and sometimes cause bronchoesophageal fistula. When the tumor metastasizes and mediastinal lymph nodes are enlarged, it can compress the recurrent laryngeal nerve and cause hoarseness. When the tumor invades the superior mediastinum and compresses the superior vena cava, the return of the head and superior vena cava is blocked, resulting in edema of the head, face, and upper limbs, which can cause headaches and dizziness or vertigo, that is, superior vena cava syndrome. Compression of the brachial plexus by the superior pulmonary sulcus tumor can cause severe pain and paresthesia in the ipsilateral shoulder joint and the inner side of the upper limb, and can also include Horner syndrome, that is, i.e., constriction of the pupil, ptosis of the upper eyelid, enophthalmos, and hypohidrosis on the forehead on the same side. Sometimes it can cause upper limb weakness and sensory impairment.