8 Lung Cancer Symptoms No One Talks About
When you have lung cancer, there are certain symptoms that may seem more obvious than others—like persistent coughing, chest pain, and difficulty breathing. But there are also symptoms that may not seem directly related to your lungs that could also be the result of this cancer. Keep reading to learn about eight symptoms that can result from lung cancer, plus, why they happen and how to manage them.
Unexplained Weight Loss
A common sign of cancer, including lung cancer, that may slip past your radar is unexplained weight loss, says Ben Creelan, M.D., an oncologist at Moffitt Cancer Center in Tampa, FL. “Anytime someone has unexplained weight loss over the course of several weeks and there isn’t a mental health component, like depression or grieving, contributing, that warrants some scrutiny,” he says. If you’re diagnosed with lung cancer and experiencing this symptom, your doctor may prescribe appetite stimulant medications or even medical marijuana in some cases to help you get the nourishment you need, he says.
Some people with tumors in the upper part of the lungs (called Pancoast tumors) may experience severe shoulder pain, according to the American Cancer Society (ACS). It’s rare, but “there can be a Pancoast tumor that pushes on the shoulder blade or brachial plexus, which is that bundle of nerves that runs from your spine to your shoulder to your arm, and that causes progressively worsening pain over the course of several weeks,” says Dr. Creelan. This kind of tumor may also lead to numbness, which if not treated quickly can lead to paralysis of your arm, he says.
Thickening of Knuckles
“Another very unusual symptom of lung cancer can cause thickening of the digits of your hand, where the knuckles become thick and stiff,” says Dr. Creelan. This is called hypertrophic osteoarthropathy, which is a condition that can occur with other types of cancers, but is most common with non-small cell lung cancer—up to 17% of cases are related to this type of lung cancer, according to a 2021 article in StatPearls. “The only real way to manage it is to treat the underlying cause, which is the cancer,” says Dr. Creelan.
Voice changes could be a symptom of lung cancer, according to the ACS—specifically, hoarseness. “Oftentimes it starts out with your voice starting to become kind of raspy or scratchy sounding, or it’s not as strong as it was,” says Dr. Creelan. “The reason for that is the tumor is actually invading one of the nerves that goes to the voice box.” You may be able to undergo a procedure (via injection or surgery) on your vocal cords to strengthen them again, he says.
Redness and Swelling of the Face
Although not common, persistent redness or swelling of the face may be a symptom of lung cancer, says Michael Wert, M.D., a pulmonary disease specialist at the Ohio State University Wexner Medical Center in Columbus, OH. “[This symptom] can be the result of a lung cancer compressing vital nerves and blood vessels within the chest and neck and always prompts urgent evaluation by a doctor,” he says.
Changes to Your Eyelids or Pupils
Eyelid changes or changes to your pupils are another less common lung cancer sign caused by compression of nerves and blood vessels that warrants a trip to the doctor, says Dr. Wert. Because they can affect nerves to the eye and face, Pancoast lung tumors can also potentially cause drooping or weakness of the upper eyelid or reduced pupil size, per the ACS.
Other uncommon symptoms that can be an indirect cause of lung cancer are called paraneoplastic phenomena, explains Dr. Wert. “For instance, lung cancer can indirectly lead to very high calcium levels that could cause confusion, excessive urination, and vomiting,” he says. “Certain types of lung cancers can cause very low sodium levels (or hyponatremia), that if severe enough can cause confusion, personality changes, or even seizures.” Researchers theorize that these symptoms occur when cancer-fighting cells and antibodies accidentally attack normal cells in the body, per the National Institutes of Health.
Signs Lung Cancer Has Spread
Cancer that has spread beyond the lungs—called metastatic cancer—can cause other symptoms as well, says Dr. Wert. “For instance, if a patient has any 'constitutional symptoms' such as drenching sweats at night, persistent/unintentional weight loss, unexplained fevers, loss of appetite, persistent fatigue, these would be considered 'red flag' signs that should prompt urgent medical attention,” he says. Other symptoms may arise depending on where the cancer has spread, he says—for example, yellowing skin (jaundice) could occur if your liver is involved, and bone involvement could lead to joint or back pain.
The Bottom Line on Lung Cancer Symptoms
Remember: Having any of these symptoms doesn’t guarantee you have lung cancer—but they are certainly warning signs to get checked out by your doctor, says Dr. Wert. The ideal ways to target lung cancer are through prevention and early detection. “The best way to diagnose lung cancer is through screening. Oftentimes, if you have symptoms, the horse is already out of the barn and it’s going to be harder to treat,” says Dr. Creelan. If you are a current or past smoker, talk to your doctor about whether lung cancer screening is right for you.
Hypertrophic Osteoarthropathy in Lung Cancer: StatPearls. (2021.) “Secondary Hypertrophic Osteoarthropathy.” https://www.ncbi.nlm.nih.gov/books/NBK513342/
Paraneoplastic Phenomena: The National Insitutes of Health. (2019.) “Paraneoplastic Syndromes Information Page.” https://www.ninds.nih.gov/Disorders/All-Disorders/Paraneoplastic-Syndromes-Information-Page
Lung Cancer Symptoms: American Cancer Society. (2019.) “Signs and Symptoms of Lung Cancer.” https://www.cancer.org/cancer/lung-cancer/detection-diagnosis-staging/signs-symptoms.html