Clinical manifestations of lung cancer

Written by Hu Zhong Dong
Medical Oncology
Updated on May 04, 2025
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The clinical manifestations of lung cancer may include fever. The reasons for the fever include possible infection, fever caused by the tumor itself, and another symptom is hemoptysis. Blood-streaked sputum or hemoptysis is a common symptom of lung cancer, accounting for about 30% of the initial symptoms. The characteristic of hemoptysis in lung cancer is intermittent and persistent, or repeated minor hemoptysis or blood streaks in sputum. Some patients may have large blood vessel ruptures, tumor cavitation leading to bronchial rupture, also causing massive hemoptysis. Some patients may exhibit coughing, with coughing as the initial symptom in about 35%-75% of cases. If a person's cough changes in nature to a high-pitched metallic sound, especially in smokers, it is crucial to be highly alert to the possibility of lung cancer. Another symptom is hoarseness, which occurs in about 20%-30% of lung cancer patients at various stages of the disease.

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Does shoulder pain mean lung cancer?

The most common cause of shoulder pain is chronic strain of the ligaments and muscles in the shoulder, not lung cancer. Lung cancer accounts for only a small portion of the reasons. If a patient has lung cancer, it can spread to the shoulder, or the lung cancer itself can produce a type of referred pain, which can cause shoulder pain. To determine the cause, it is necessary to go to the hospital for an X-ray of the shoulder joint or a plain chest film, as well as an MRI of the shoulder joint, to clarify the cause of the shoulder pain. If the pain is solely due to the muscles or ligaments in the shoulder, it can be relieved through conservative treatments such as massage, acupuncture, electrotherapy, and magnetotherapy.

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Symptoms of brain metastasis from lung cancer

Brain metastasis of lung cancer is caused by hematogenous spread of lung cancer to the brain. Brain metastasis typically presents with symptoms such as headaches, nausea, and vomiting, including projectile vomiting. The headaches may be severe, and there may be abnormalities in sensory perception and motor function, possibly accompanied by seizures, mental confusion, olfactory disturbances, visual impairments, and other symptoms. The specific symptoms can vary depending on the location of the metastasis in the brain. However, most patients experience headaches, nausea, and vomiting. Individual differences are significant, and it's important to analyze the specific issues and the specific areas of the brain affected.

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How is lung cancer diagnosed?

Lung cancer is one of the malignant tumors and falls under respiratory system diseases. The gold standard for the diagnosis of malignant tumors is biopsy. Thus, lung cancer is no exception; it requires a biopsy and immunohistochemistry to determine the type of cancer and its pathological type. So how is the biopsy obtained? We can use a bronchoscope to directly observe the tumor and collect small tissue samples for pathological examination. Additionally, there is the thoracic wall lung puncture biopsy, where tissue from the tumor can be sampled using a fine needle. These samples are observed under a microscope to differentiate the pathological types and to further confirm the diagnosis.

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Small cell lung cancer and non-small cell lung cancer differences

Small cell lung cancer and non-small cell lung cancer are both types of primary bronchogenic carcinoma, differing only in their cellular morphology. They also differ in clinical symptoms and characteristics of metastasis. Small cell lung cancer is more prone to metastasis clinically, including strenuous and distant spread, such as to the brain and liver. The medications used for each are also different; small cell lung cancer typically involves chemotherapy drugs like etoposide and cisplatin, whereas non-small cell lung cancer commonly uses drugs like paclitaxel and platinum-based drugs.

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What department should lung cancer patients visit?

The first point is that lung cancer can be categorized as a respiratory system disease, so one could visit the respiratory department. However, the respiratory department is not specialized enough for lung cancer, so it is recommended to visit the oncology department instead. After all, lung cancer is a malignant tumor. Initially, one can visit the respiratory department, but once it is confirmed through biopsy that it is lung cancer, it is advised to seek specialized treatment in the oncology department, as it is a malignant tumor.