Lung Cancer (Non-Small Cell)

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Early Detection, Diagnosis, and Staging TOPICS

Signs and symptoms of non-small cell lung cancer

Most lung cancers do not cause any symptoms until they have spread too far to be cured, but symptoms do occur in some people with early lung cancer. If you go to your doctor when you first notice symptoms, your cancer might be diagnosed at an earlier stage, when treatment is more likely to be effective. The most common symptoms of lung cancer are:

  • A cough that does not go away or gets worse
  • Chest pain that is often worse with 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 don’t go away or keep coming back
  • New onset of wheezing

When lung cancer spreads to distant organs, it may cause:

  • Bone pain (like pain in the back or hips)
  • Neurologic changes (such as headache, weakness or numbness of an arm or leg, dizziness, balance problems, or seizures), from cancer spread to the brain or spinal cord
  • Yellowing of the skin and eyes (jaundice), from cancer spread to the liver
  • Lumps near the surface of the body, due to cancer spreading to the skin or to lymph nodes (collections of immune system cells), such as those in the neck or above the collarbone

Most of the symptoms listed above are more likely to be caused by conditions other than lung cancer. Still, if you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated, if needed.

Some lung cancers can cause a group of very specific symptoms. These are often described as syndromes.

Horner syndrome

Cancers of the top part of the lungs (sometimes called Pancoast tumors) may damage a nerve that passes from the upper chest into your neck. This can cause severe shoulder pain. Sometimes these tumors can affect certain nerves to the eye and part of the face, causing a group of symptoms called Horner syndrome:

  • Drooping or weakness of one eyelid
  • Having a smaller pupil (dark part in the center of the eye) in the same eye
  • Reduced or absent sweating on the same side of the face

Conditions other than lung cancer can also cause Horner syndrome.

Superior vena cava syndrome

The superior vena cava (SVC) is a large vein that carries blood from the head and arms back to the heart. It passes next to the upper part of the right lung and the lymph nodes inside the chest. Tumors in this area may push on the SVC, which can cause the blood to back up in the veins. This can cause swelling in the face, neck, arms, and upper chest (sometimes with a bluish-red skin color). It can also cause headaches, dizziness, and a change in consciousness if it affects the brain. While SVC syndrome can develop gradually over time, in some cases it can become life-threatening, and needs to be treated right away.

Paraneoplastic syndromes

Some lung cancers can make hormone-like substances that enter the bloodstream and cause problems with distant tissues and organs, even though the cancer has not spread to those tissues or organs. These problems are called paraneoplastic syndromes. Sometimes these syndromes may be the first symptoms of lung cancer. Because the symptoms affect organs besides the lungs, patients and their doctors may suspect at first that a disease other than lung cancer is causing them.

Some of the more common paraneoplastic syndromes that can be caused by non-small cell lung cancer include:

  • High blood calcium levels (hypercalcemia), which can cause frequent urination, thirst, constipation, nausea, vomiting, belly pain, weakness, fatigue, dizziness, confusion, and other nervous system problems
  • Excess growth of certain bones, especially those in the finger tips, which is often painful
  • Blood clots
  • Excess breast growth in men (gynecomastia)

Again, many of the symptoms listed above are more likely to be caused by conditions other than lung cancer. Still, if you have any of these problems, it’s important to see your doctor right away so the cause can be found and treated, if needed.


Last Medical Review: 08/15/2014
Last Revised: 12/12/2014