Lung Cancer
Lung cancer - signs, symptoms and delay in diagnosis
It is important to note that signs and symptoms similar to those caused by lung cancer may be due to other less serious problems. However, one factor affecting survival for patients with lung cancer is the extent to which the tumour has spread at diagnosis, which in turn depends on how the tumour is discovered, and how quickly the patient sees the doctor.
Symptoms of lung cancer can be like those caused by other diseases, such as chronic bronchitis or heart disease, and may at first be misdiagnosed, especially if there is a history of other health problems. One man who complained of low back pain was investigated for bowel, kidney, stomach and liver problems. Only when a lump appeared between his neck and his shoulder blade was he sent for a chest X-ray, which showed lung cancer.
He went to the hospital with chest pains which were at first diagnosed as angina.
He went to the hospital with chest pains which were at first diagnosed as angina.
Finished off our weekend and returned to the family home, contacted the family doctor and told him what was happening and he said he would phone me back in five minutes. He phoned me back in five minutes and said "I want you to get up to the hospital right now. If there's any problem with transport I'll organise it but you must get, can you get up there right now?" I said "Yes my wife will take me up right now." He said "Right they're waiting for you."
So I went up to the A & E and went through various tests there and transferred from the A & E into the ERU, that's the Emergency Receiving Unit in the hospital. And they continued with the tests and was told it was, that I had prolonged angina attack and this was the line of their enquiries. And they kept me in the ERU from the Monday until the Friday and on the Friday afternoon a doctor came in and she told me she had good news for me and she says "[Name] you do not have a prolonged angina attack, what you have got is a tumour in your right lung and the tumour in our experience it's of a cancerous nature."
Some people only discovered they had lung disease during a routine medical check-up or when consulting their doctor about another matter. One man went to his GP for a prescription and his GP noticed 'clubbing' of his finger nails, a sign of lung cancer, but also of various other diseases.
His lung cancer was found after he consulted his GP about another matter.
His lung cancer was found after he consulted his GP about another matter.
And I was in the chest clinic at half 11 in the morning, I think it was a Thursday morning, I got a phone call on the Monday saying would I come back for a more thorough x-ray done on a bigger plate I think. And all of the time I was thinking, 'Well of course there's bits of crusty old muck on my chest I've been smoking for 34 years.' The last thing I thought it was lung cancer, it never crossed my mind. And when it did I dismissed it as not being likely. So then I was referred for a CT scan and by now the professionals must be fairly confident I have lung cancer and I'm still blissfully unaware of this thinking they're all wrong.
Fatigue, breathlessness and loss of weight are common with lung cancer. Chest pain or discomfort can occur; one woman had pain down her arm and numb fingers.
She first consulted her doctor because of a painful arm and numb fingers.
She first consulted her doctor because of a painful arm and numb fingers.
Loss of voice may also indicate that something is wrong. One man initially thought it was due to a chest infection, but it was a sign that lung cancer had recurred. Swelling of the face or neck may also be a sign of lung cancer.
His loss of voice was a sign that the cancer had recurred.
His loss of voice was a sign that the cancer had recurred.
And we was running some raffles at the hospital for the Roy Castle Foundation, they had a month of raffles and a fundraising month for the Roy Castle Foundation and I went to the hospital one day to run a raffle and when I got there my voice had gone completely. And the lung cancer support nurse saw me while I was there, she was instructing me on what to do with the raffle and she said "How long has your voice been like that?" And I explained to her and she sent me straight down for a chest x-ray there and then. And when it came back she called me into her room and said "It looks as if your cancer has come back again," or "You've got a cancer back again." She said "I'm referring you to the surgeon who did your operation."
Some people diagnosed with lung cancer had repeated chest infections that did not respond to antibiotics. Many others complained of a persistent cough and some found blood in their sputum or were coughing up quite large amounts of blood.
Initially he had repeated chest infections that did not respond to antibiotics.
Initially he had repeated chest infections that did not respond to antibiotics.
Yeah well I first noticed, first took ill in December 99 for the really severe chest infection. Went to my GP, had a course of antibiotics, which was like a seven day course, completed the course and the chest infection cleared, and then five days later it was all back again. Went back to my GP, who asked me if I'd finished the course and I said, 'Yes, of course'. Gave me another course of antibiotics, completely finished that course, completely cleared up, five days later back again. So she sent me down the hospital for a chest x-ray.
His initial symptoms included a persistent cough and blood in the sputum.
His initial symptoms included a persistent cough and blood in the sputum.
So anyway eventually in May I was offshore and I woke up one morning, washed, shaved, cleaned my teeth, cleaning my teeth, spat in the sink as you do when you're cleaning your teeth, blood. My gums don't bleed, blood, strange mm. So swilled my mouth out, coughed again and sure enough again more blood. This went on for the fortnight I was offshore so on the Monday previous to me coming home I phoned up my GP and asked for an appointment and that was the 5th, 16th of May. As soon as I went in there and asked what was wrong, I said "I'm spitting up blood," he said "We're going to have to get you an appointment for an x-ray." The next day I went for my x-ray, the x-ray came back on the following Monday and I was told then that I had a shadow on my left lung.
The first sign that anything was wrong was when he coughed up a load of thick blood.
The first sign that anything was wrong was when he coughed up a load of thick blood.
So, you know at that time we were undecided what to do, I thought it was, it was from me nose or something like that you know. And with it being the holiday period we thought I'd go to the pharmacist and get some advice or something.
And I don't know what made me do it but I insisted that I go to hospital. And I went down to the local hospital. Anyway they done some tests on me then because I'd presented, I forget what they call it like coughing blood up, x-rayed and they couldn't find anything and the blood had stopped coming. But they decided then that because of the way I presented they would ask me to come in the following Wednesday to do some tests. And it was quite a shock to me you know, I'd never been in hospital before.
Early diagnosis of mesothelioma (a type of lung cancer) is difficult. The first obvious sign of illness may be when an 'effusion' occurs. This is an accumulation of fluid which gathers in the pleural space around the lung, (or in the peritoneal space in the abdomen), which causes breathlessness. However, other symptoms may occur too. One man with mesothelioma initially complained of chest pain and a dull ache in his shoulder. Another man had backache, a 'croaky voice', weight loss and breathlessness. Several tests and biopsies may be necessary to confirm the diagnosis, and this can take a few weeks.
His first symptom of mesothelioma was shortness of breath.
His first symptom of mesothelioma was shortness of breath.
When it got to noticing the difference just with a short walk, I thought, 'Well this can't be natural. This can't just be the fact that I'm in my early sixties, this can't be right. So that's when I first went to the doctor. The doctor was absolutely amazed and said she, my local GP, she listened, put the stethoscope on me, and sort of listened to the lungs, and she obviously didn't like what she heard. And she said, 'There's something going on there and I think we need to investigate this pretty quickly', she said. 'You should really shouldn't have left it this long', and I said, 'Well you don't see me very often'. I actually know her quite well, but, because of helping her out with computers rather than because I'm her patient.
She referred me straightaway to the local hospital. I went to the local hospital, was introduced to a specialist there, in the Chest Clinic, and he straightaway said, 'Chest X-ray', took me through to the Chest X-ray department. Now that was, by this time it was sort of end of February, last year, 2002. The X-rays came back the same day, and his immediate reaction was, 'You shouldn't be walking around like this', because he realised that, well the X-ray showed, that the largest part of the left, the left part, left lung, was, shrouded in fluid, and I was actually running on one lung. And that's why I was short of breath, all quite logical really.
Before mesothelioma was diagnosed he had a suspected chest infection, pain in the chest, and pain in the shoulder.
Before mesothelioma was diagnosed he had a suspected chest infection, pain in the chest, and pain in the shoulder.
Well it all started February, I had a terrible cold, well I thought it was a cold for about three weeks and I kept coming to work instead of having a week or two off so I could finish this job you know. So I kept going in and it seemed to get worse. And then we went away for Easter 2002 down to my wife's auntie's in Folkestone and I got struck there with pleurisy and it was really painful, it doubled me up.'..
So I went on penicillin, a course of penicillin for a week and pain killing tablets and that seemed to get rid of it. So I went down my own doctors to notify him what had happened and he sent me for an x-ray locally and they said there was something wrong so they sent me down the hospital. And they took more x-rays and then they wanted me to have a scan. So I had a scan as well and they thought it might be to do with asbestos. And then I had to go for a lung biopsy which was one hundred percent it was mesothelioma.
But getting back to when I was first diagnosed with mesothelioma it wasn't only just the pain in my chest I used to have a pain right up in my shoulder, it was like a dull ache for ages you know and they give you pain killers to help that which it does, you know it kills the pain a bit so it makes you feel better. Because when I was putting up with that, because I don't like taking pills if I can help it, I'm not that sort of person, but at the end of the day I had to have something because it was like having a toothache in your shoulder all the time and you had to have something to stop it you know.
Sometimes people delayed seeking help because they had no symptoms, or because they did not associate symptoms such as tiredness with serious illness, or because the symptoms did not bother them. One woman delayed seeking help for eight months, even though her weight had dropped to five stone - she thought the weight loss was due to worry about a family problem.
She delayed seeking help for her cough because she did not think she had a serious problem.
She delayed seeking help for her cough because she did not think she had a serious problem.
How many months do you think you delayed with the cough not knowing whether to go to the doctor or not?
'only about six months. But it was, the cough was no trouble to me at all. A few people commented "Have you started smoking, you've got a smoker's cough," but I, it was something that crept up on me and I really didn't take it seriously because I was not the sort of person that's paranoid about health, I just thought may be I've got a, I don't know what I thought but it didn't occur to me.
Last reviewed May 2016.
Last updated May 2012.
Copyright © 2024 University of Oxford. All rights reserved.