Signs and Symptoms of Small Cell Lung Cancer

Most lung cancers do not cause any symptoms until they have spread, but some people with early lung cancer do have symptoms. 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.

Most of these symptoms are more likely to be caused by something 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. The most common symptoms of lung cancer are:

  • A cough that does not go away or gets worse
  • Coughing up blood or rust-colored sputum (spit or phlegm)
  • Chest pain that is often worse with deep breathing, coughing, or laughing
  • Hoarseness
  • Weight loss and loss of appetite
  • 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 other parts of the body, it may cause:

  • Bone pain (like pain in the back or hips)
  • Nervous system changes (such as headache, weakness or numbness of an arm or leg, dizziness, balance problems, or seizures), from cancer spread to the brain
  • 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 (collection of immune system cells) such as those in the neck or above the collarbone

Some lung cancers can cause syndromes, which are groups of specific symptoms.

Horner syndrome

Cancers of the upper part of the lungs are sometimes called Pancoast tumors. These tumors are more likely to be non-small cell lung cancer (NSCLC) than small cell lung cancer (SCLC).

Pancoast 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
  • 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

Pancoast tumors can also sometimes cause severe shoulder pain.

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 can press on the SVC, which can cause the blood to back up in the veins. This can lead to 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 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 other organs, patients and their doctors may first suspect that a disease other than lung cancer is causing them.

Some of the more common paraneoplastic syndromes associated with SCLC are:

  • SIADH (syndrome of inappropriate anti-diuretic hormone): In this condition, the cancer cells make a hormone (ADH) that causes the kidneys to retain (hold) water. This lowers salt levels in the blood. Symptoms of SIADH can include fatigue, loss of appetite, muscle weakness or cramps, nausea, vomiting, restlessness, and confusion. Without treatment, severe cases may lead to seizures and coma.
  • Cushing syndrome: In this condition, the cancer cells make ACTH, a hormone that makes the adrenal glands secrete cortisol. This can lead to symptoms such as weight gain, easy bruising, weakness, drowsiness, and fluid retention. Cushing syndrome can also cause high blood pressure and high blood sugar levels, or even diabetes.
  • Nervous system problems: SCLC can sometimes cause the body’s immune system to attack parts of the nervous system, which can lead to problems. One example is a muscle disorder called Lambert-Eaton syndrome. In this syndrome, muscles around the hips become weak. One of the first signs may be trouble getting up from a sitting position. Later, muscles around the shoulder may become weak. A rarer problem is paraneoplastic cerebellar degeneration, which can cause loss of balance and unsteadiness in arm and leg movement, as well as trouble speaking or swallowing. SCLC can also cause other nervous system problems, such as muscle weakness, sensation changes, vision problems, or even changes in behavior.

Again, many of these symptoms can also be caused by something 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.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: February 22, 2016 Last Revised: May 16, 2016

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.