How do those with lung cancer present

How do those with lung cancer present

Read lung cancer first.

The early symptoms of lung cancer and their prevalence include:

  • Cough or altered cough in 60% of patients.
  • Coughing blood( Haemoptysis) in  27% of cases
  • Chest pain in 34%.
  • Difficulty in breathing (Dyspnea) in 46% of cases.
  • Loss of appetite
  • Weight loss 56%.

On examination of the patients

These findings are common

  • An opacity in the lung on a chest x-ray
  • Enlarged lymph nodes in the neck, clavicular spaces and/or armpits.
  • Spread to the brain, bones, lungs, liver, and adrenal glands.
  • Paraneoplastic syndromes such as:
    1. Eaton-Lambert syndrome: myopathy involving proximal muscle groups
    2. Endocrine manifestations: hypercalcemia, ectopic ACTH, SIADH
    3. Neurologic: subacute cerebellar degeneration, peripheral neuropathy, cortical degeneration
    4. Musculoskeletal: polymyositis, clubbing, hypertrophic pulmonary osteoarthropathy
    5. Hematologic or vascular: migratory thrombophlebitis, marantic thrombosis, anemia, thrombocytosis, or thrombocytopenia
    6. Cutaneous: acanthosis nigricans, dermatomyositis
  • Pleural effusion in 10% of patients
  • Localized wheezing
  • Superior vena cava syndrome ( in 0-4% of patients) presenting with
    1. Signs of obstruction of venous return to the superior vena cava.
    2. Persistent headache, nausea, vomiting, dizziness, visual disturbances, syncope, and difficulty in breathing.
    3. Prominent distention of thoracic and neck veins, facial swelling and upper extremities, facial plethora, and bluish coloration of skin (cyanosis).
  • Horner’s syndrome a condition that presents with constriction of the eye pupils, drooping of the eyelids (ptosis), facial anhidrosis (disorders of sweating) caused by spinal cord damage between spinal nerves of C8 and T1 secondary to a superior sulcus tumor. A superior sulcus tumor associated with ipsilateral Horner’s syndrome and shoulder pain is known as “Pancoast” tumor.

Those at risk of developing lung cancer include:

  • Middle-aged populations and those over 45 years of age
  • Those who smoke and present with
    1. Altered characteristics of unusual cough;
    2. Coughing blood (Haemoptysis)
    3. Patients presenting with recurrent pneumonia;
    4. Weight loss and impaired general condition.
  • Current and former smokers. You present your body to too many carcinogens (substances that can cause cancer). Studies show that the cumulative risk of dying from lung cancer for a lifelong smoker is estimated to be approximately 16% in men and approximately 10% in women
  • Those with various occupational exposures such as asbestos
  • The presence of airflow obstruction
  • Family history of lung cancer
  • Those with a prior history of a cancer of the aero-digestive tract.
  • Altered genes

The differential diagnosis

The list of possible causes of patients presenting with feature of lung cancer includes:

  • Pneumonia
  • Tuberculosis
  • Metastatic carcinoma to the lung
  • Abscess
  • Carcinoid tumor
  • Fungal diseases
  • Sarcoidosis
  • Heat failure
  • Pleural effusion due to heart failure, pneumonia, TB, ascites, pancreatitis, and collagen-vascular

Continue reading What are some of the tests done in lung cancer?

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