Lung cancer is the leading cause for cancer related deaths worldwide. And it usually peaks at about 50 to 69 years. However, approximately 2% of lung cancers occur before the age of 40. Unlike some other types of cancers, lung cancer has a very poor prognosis, since most of them are diagnosed at a late stage. Most patients who develop lung cancers are smokers, and have smoking related damage to the heart and lungs.
Other causes for lung cancer include, exposure to substances such as Radon, Asbestos, Halogen ether, Arsenic, Ionizing radiation, Chromium, Nickel, Vinyl chloride. Chronic interstitial pneumonitis. And environmental pollution.
Lung cancers can be broadly categorized in to primary, and secondary malignancies. Primary lung cancers are generally divided in to 2 main groups. Small cell lung cancer; And non small cell lung cancer, which accounts for about 85% of the total lung cancer cases. Histologically, non small cell lung cancers are further divided in to Adeno carcinoma; Squamous cell carcinoma; And Large cell carcinomas. Secondary lung cancers occur when a cancer had started elsewhere in the body, and spreads in to the lungs through blood or lymphatics. This is called metastasis of the initial tumor.
Lung cancers are often insidious, producing no symptoms until the disease is well advanced. But, about 7 to 10% of lung cancers are diagnosed early in asymptomatic patients when a chest radiograph performed for other reasons. At the initial diagnosis, about 20% of patients have only the localized disease. About 25% of patients have regional metastasis. And about 55% of patients have distant spread of the cancer, which makes the prognosis extremely poor.
Symptoms due to the primary tumor include, Cough, which is the commonest complaint of lung cancer patients. Wheezing, due to airway obstruction. Post obstructive pneumonia, caused by accumulation of secretions distal to the obstruction that is complicated by infection. Shortness of breath. Coughing up blood, also known as hemoptysis.
Pleural effusions. And chest pain.
Symptoms due to loco regional spread include,
Paralysis of the recurrent laryngeal nerve can cause hoarseness, or complete loss of voice; And Difficulty in breathing. Paralysis of the phrenic nerve can cause diaphragmatic paralysis, which can cause difficulty in breathing. And pressure on the sympathetic plexus can cause Horner’s syndrome, which is characterized by a triad of symptoms. Anhydrosis, or absence of sweating in the affected side, partial ptosis, or partially closed eye lid, and miosis, or constricted pupil.

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Symptoms due to distant spread include, spinal cord compression. Brain metastasis can cause headache; Altered mental status; Seizure; Nausea & vomiting. Musculoskeletal involvement can cause muscle & bone pain.
Other non specific signs & symptoms of lung cancer include, Finger clubbing; Loss of appetite; And weight loss.