Lung cancer may not be the most common cancer diagnosis in the United States—that would be prostate cancer for men and breast cancer for women—but it is by far the leading cause of cancer death in the country, per the American Cancer Society (ACS). Still, knowing the surprising signs of lung cancer, even if you don’t have a history of smoking, can help you get the treatment you need to improve your prognosis.
According to the ACS, about 85% of lung cancer deaths are caused by smoking tobacco. However, it’s not the only risk factor. Exposure to radon (an odorless gas found in homes) is often to blame, said Robert McKenna, M.D., a thoracic surgeon at Providence Saint John’s Health Center in Santa Monica, CA. Other possible culprits that increase your lung cancer risk include air pollution, secondhand smoke, and environmental hazards like asbestos.
Meet the experts: Robert McKenna, M.D., a thoracic surgeon at Providence Saint John’s Health Center in Santa Monica, CA; Jack Jacoub, M.D., a hematologist/oncologist and the former medical director of the MemorialCare Cancer Institute in Fountain Valley, CA.
Read on to discover the signs of lung cancer you should be aware of, including how to distinguish them from a run-of-the-mill virus or infection and when you should give your doctor a call.
Surprising lung cancer symptoms
A lingering cough
A cough that gets worse and more intense over time is the number-one sign of lung cancer. “The majority of people with lung cancer have a cough, occasionally with blood,” said Dr. McKenna. Bringing up thick, rust-colored mucus can also be an early sign. However, a dry cough that has persisted for more than a month and does not respond to antibiotics is also worth getting checked out.
Chest pain
Chronic chest pain is one of the most obvious signs of lung cancer, especially if it becomes more intense when breathing deeply, coughing, or laughing, per the ACS. Take note if the pain travels to your back and shoulders. Regardless of whether the pain is dull or sharp, talk to your doctor if you notice it persisting.
Chronic infections
Most of the time, viruses or bacteria are to blame for lung infections like bronchitis and pneumonia. However, if you’re repeatedly getting sick and every illness seems to go straight to your chest, it could be a sign of lung cancer, according to the ACS. Research in the International Journal of Molecular Sciences explains that because chronic inflammation plays a role in the development of lung cancer, bacterial infections like those above are also associated with the disease. Moreover, people with non-small cell lung cancer have a higher risk for recurrent infections.
Unexplained weight loss
Losing weight for seemingly no reason, without a change in your diet or workout? “As with any cancer, a more advanced tumor may make proteins that tell your body to lose weight,” explained Dr. McKenna. You may also notice a drop in your appetite.
Bone pain
If lung cancer has spread to other organs in your body, you may feel an ache deep down in your bones or joints, said Jack Jacoub, M.D., a hematologist/oncologist and the former medical director of the MemorialCare Cancer Institute in Fountain Valley, CA. The back and hips are common sore spots.
Swelling in your neck and face
If a lung tumor begins pressing against your superior vena cava (the large vein that carries blood from your head and arms to your heart), you may notice swelling in your neck and face, said Dr. Jacoub. Your arms and upper chest can also be affected. Known as superior vena cava syndrome, this can also cause trouble breathing, headaches, and dizziness, per the ACS.
Overwhelming fatigue
“This is different than feeling tired,” said Dr. Jacoub. “It’s feeling so worn out that you can’t wait to climb into bed,” and getting lots of rest doesn’t help. According to the Cleveland Clinic, between 80% and 100% of people with cancer experience “cancer fatigue,” or whole-body exhaustion no matter how much sleep you get. However, many different health and lifestyle factors can make you feel tired all the time, so be sure to talk to your doctor to ensure you pinpoint the right source of your fatigue.
Muscle weakness
Lung cancer affects your muscles as well as your organs. One of the first areas to be impacted is your hips. “You might find it hard to even get out of a chair,” said Dr. Jacoub. Weakness in the shoulders, arms, and legs is also typical. Lung cancer cells can produce certain hormones or cause your immune system to attack parts of your nervous system that directly affect your muscles, resulting in weakness, per the ACS.
High calcium levels
Certain lung cancers make hormone-like substances that upset the balance of minerals in your body. In some instances, said Dr. McKenna, excess calcium gets released into the bloodstream, which can weaken your bones, cause kidney stones, or affect the heart and brain, according to the Mayo Clinic. While you may not realize your levels are through the roof until your doctor orders a lab test, you should keep an eye out for symptoms of high calcium, such as frequent urination, excessive thirst, constipation, nausea, belly pain, and dizziness.
This article was originally published in 2019 and has since been updated.
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