5 Early Signs of Lung Cancer You Need to Know

And when to get them checked out.
an illustration of lungs with a stethoscope on them
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Lung cancer—not breast or uterine or ovarian cancer—claims more women’s lives every year than any other type of cancer. One of the reasons is that there are so few early signs of lung cancer—and there’s no proven screening test for detecting the disease in its early stages. So the majority of patients are diagnosed once the cancer is advanced and has spread elsewhere in the body. Fortunately, it is now recommended that people at a high-risk for lung cancer (like current and former smokers) get a low-dose CT scan to screen for the cancer, according to the American Lung Association. You can learn more about that here.

Once lung cancer has advanced, it usually causes more noticeable symptoms such as back pain, headaches, weight loss, and fatigue. Bone pain is also common, because that’s where lung cancer tends to spread first, Andrea McKee, M.D., chairperson of radiation oncology at the Lahey Hospital and Medical Center Sophia Gordon Cancer Center in Burlington, Massachusetts, tells SELF. McKee also serves on the Lung Association's Lung Cancer Expert Medical Advisory Panel and works with their LUNG FORCE initiative to help raise awareness and educate women about lung cancer.

Although the majority of people diagnosed with lung cancer don’t experience obvious symptoms in its early stages before it spreads, some people may present with these subtle early signs of lung cancer. However, remember that these symptoms may be associated with many conditions and are only rarely a sign of lung cancer. Still, it’s important to be aware of any unexplained changes to your breathing.

1. A new, chronic cough.

This is the symptom most likely to show up early on."Sometimes in the periphery [of the lungs] a tumor can just keep growing to a relatively large size before we’ll diagnose it because it won't cause very many symptoms," Dr. McKee explains. But if a tumor is pushing on one of the bronchi, the major air passages going to the lungs, it will likely trigger the cough receptors. "It can trigger a cough even if the tumor is relatively small," she explains, if it's pushing on the right spot.

But a cough is a very non-specific symptom. And when you have one, cancer is not the first thing you think of (nor should it be). Both the common cold and flu can persist for a few weeks. And if you have sensitive lungs, it’s not unusual for your cough to linger even after the runny nose and other symptoms go away. “You don’t need to necessarily be worried about lung cancer in that situation if it’s associated with a viral illness,” Dr. McKee reassures.

But if you have a cough that persists for two or three weeks and is not connected to any virus or bacterial infection, that’s a sign that you should see a doctor.

2. Shortness of breath.

A new feeling of shortness of breath is another potential lung cancer symptom, according to the American Cancer Society. The technical term for this symptom is “dyspnea” and, although it tends to become noticeable only in later stages of the disease, it might show up if you have a tumor that’s obstructing your airway. Any unexplained shortness of breath should be investigated by a doctor.

3. Coughing up blood.

“Some patients will cough up blood if the tumor is close to the bronchi,” Dr. McKee explains. If you’re ever coughing up blood or rust-colored phlegm without explanation—even a small amount—see a doctor ASAP. If you’re also experiencing any lightheadedness, dizziness, or shortness of breath, it’s especially important to seek medical attention.

4. Chest pain.

If lung cancer has spread to the chest wall or caused swollen lymph nodes in the area, it can cause aching pain in the chest, back, or shoulders. Chest pain caused by lung cancer tends to get worse when you cough, laugh, or breathe deeply, the ACS says.

Because chest pain can be a sign of several serious conditions, it’s important to talk to your doctor if you have any unexplained discomfort in the area. Any chest pain that’s persistent or severe should be investigated. And if you’re experiencing any other characteristic symptoms of a heart attack—such as crushing pressure in the chest, sweating, nausea, dizziness, or shortness of breath—that qualifies as a medical emergency and means you should get to a doctor ASAP.

5. Hoarseness or wheezing.

Breathing issues associated with lung cancer don’t always present as shortness of breath. They might show up as something more subtle instead, such as hoarseness or wheezing, the ACS explains. If you notice any persistent changes in your breathing, it’s important to get them checked out by a doctor.

Being able to recognize these super subtle symptoms can help you catch lung cancer in its beginning stages, which is crucial.

“There’s a big difference in terms of survival between early detection and late detection when it comes to lung cancer,” Dr. McKee says. In fact, the five-year survival rate for those diagnosed with late-stage lung cancer is under 10 percent. But when lung cancer is detected in its earliest stages, it’s much more likely that the patient will have success with their treatment, Dr. McKee says.

Marlo Palacios, a 42-year-old lung cancer patient in Pasadena, California, was diagnosed after she saw her doctor for a persistent cough. “I developed a cough from what I initially assumed was a cold caught by my son,” Palacios tells SELF. After a few weeks, the cough didn’t go away. “I didn’t want to make a big deal of it, so I didn’t see my physician immediately. I had even made an appointment three weeks into the cough, but I cancelled it.”

A few weeks later, she finally decided to see a doctor. “I had to come to terms that this cough wasn’t going away and that it didn’t feel as though it was from a common cold,” she says. “The cough was dry, and it would come in intense waves. I would cough uncontrollably when this happened, to the point where I was gagging and couldn’t catch my breath.” After seeing a handful of doctors, she was diagnosed with stage IV lung cancer. “As a never-smoker, this was an initial shock to me and everyone in my life,” Palacios says.

Ashley Rivas, a 35-year-old lung cancer survivor from Albuquerque, New Mexico, shares a similar story about her diagnosis. Her symptoms started as wheezing during exercise, and her doctor prescribed an inhaler for activity-induced asthma. “The medicine helped a little bit but never eliminated the symptoms,” she tells SELF.

A few years later, Rivas developed a dry cough. At first, it was just “a lingering annoyance, but nothing that caused much concern,” Rivas explains. Within the year, it became more aggressive. “It sounded hollow or drum like. It was coming from deep inside my chest and was very painful. It was worse at night and was accompanied with a fever.” The coughing remained, but she never felt sick enough to see a doctor.

Eventually, Rivas went for an X-ray, and was diagnosed with pneumonia. A few weeks later, she was very fatigued and had a fever. She knew something wasn’t right—finally, additional X-rays and tests revealed a cancerous tumor had been growing on her right lung.

At the end of the day, you can’t go wrong with listening to your body and being cautious.

Seeing a doctor when something doesn’t feel right will help you catch the early signs of lung cancer—or any other health problem. Although not everyone with lung cancer develops these symptoms early on, these are the symptoms most likely to appear before the disease spreads and becomes more serious.

A chronic cough, wheezing, or feeling out of breath could also be a signs of acid reflux, asthma, or a side effect of medication, Dr. McKee says. And any unexplained sensation of having difficulty breathing deserves medical attention. “Those are all things you want your doctor to weigh in on,” Dr. McKee says.

Even if it’s not the worst-case scenario, you’ll be glad you got treatment and finally kicked that pesky cough.