Lung Cancer Signs and Symptoms

Lung cancer occurs when abnormal cells grow in your lung tissue. It is the leading cause of cancer deaths in the United States. Kentucky has the highest rates of new lung cancer cases in the nation. Lung cancer is mostly diagnosed in people age 70 and older. Symptoms include shortness of breath and fatigue. Lung cancer screening, especially if you are at high risk, can discover lung cancers early and lead to more successful cancer outcomes. Treatment for lung cancer includes chemotherapy, radiation and surgery.

There are two types of lung cancer: 

Small cell lung cancer (SCLC) grows quickly and is difficult to treat. It often starts as a relatively small tumor that spreads to other parts of the body. Specific types of SCLC include small cell carcinoma (kar-seh-NO-mah) and combined small cell carcinoma. 

Non-small cell lung cancer (NSCLC) grows more slowly than SCLC. It is also more common than small cell lung cancer. About 80% of lung cancer cases are NSCLC. Specific but less common types of this cancer include adenosquamous (ah-DEE-no-skway-muss) carcinoma and sarcomatoid (sar-koh-MA-toyd) carcinoma. 

Other kinds of lung cancer can start in the tissue around the lungs but aren’t called lung cancer. Lymphomas are cancers that begin in the lymph nodes. Sarcomas start in the bone or soft tissue. Pleural mesothelioma (MESS-oh-thee-lee-oh-ma) affects the lining of the lungs. 

Signs and Symptoms

Lung cancer can grow in the body for many years without any symptoms in the early stages. If symptoms are present, they often feel similar to other less-serious illnesses. More obvious symptoms develop in the later stages of lung cancer. It is important to have regular lung cancer screening if you are at a high risk or have a family history of lung cancer.

Symptoms can include:

  • Trouble breathing or shortness of breath, even without activity
  • Cough that doesn’t get better or gets worse over time
  • Wheezing
  • Hoarseness
  • Chest pain, pressure or discomfort
  • Difficulty taking a full breath in
  • Coughing up blood
  • Loss of appetite
  • Unexplained weight loss
  • Tiredness even with adequate rest
  • Swelling in the neck, face, arms or upper chest area

Some conditions have similar symptoms of lung cancer. A cough or pneumonia that keeps coming back after treatment sometimes can be an early sign of lung cancer. 

See a doctor if you have a cough that won’t go away, have unusual shortness of breath, are coughing up blood or have extreme fatigue. Also see a doctor if you have any combination of symptoms that concern you.

If you are at higher risk for lung cancer, you should be screened regularly by a health care provider. 


Smoking is the best-known and best-studied cause of lung cancer. Cigarette smoking causes 80% to 90% of lung cancer deaths in the United States. The more cigarettes you smoke, the higher your risk for developing lung cancer. Even if you don’t smoke, if you are around someone who smokes, you are at higher risk for lung cancer from secondhand smoke. Adults who do not smoke but who are exposed to secondhand smoke have a 20% to 30% increased risk of developing lung cancer. Sometimes there is no known trigger for lung cancer.

Researchers believe that smoking damages the cells of the lungs. Cigarettes have chemicals in them that are known to cause cancer (called carcinogens). Your body can repair some of this damage, but continued exposure to smoking causes too much damage for the body to repair. The damaged cells may begin growing out of control. 

Diagnosis and Treatment

Depending on your specific situation, your health care provider may want to screen you before you have symptoms. If you have a higher risk for lung cancer, or a family history of the disease, early yearly screenings may be recommended. Talk with your doctor to see which lung cancer testing might be right for you.


  • Imaging tests: An X-ray image of your lungs may reveal an abnormal group of cells. A CT scan can reveal small spots in your lungs that might not be detected on an X-ray.
  • Sputum cytology: If you have a cough and are producing sputum (the thick white or yellow mucus that comes out when you cough), looking at the sputum under the microscope can sometimes show cancer in the lungs.
  • Tissue sample (biopsy): A small piece of abnormal cells may be removed in a procedure called a biopsy.
  • Wedge resection: This procedure removes a small piece of the lung, including a little healthy tissue around the edges of the abnormal section.

Lung Cancer Biopsy

Norton Cancer Institute has a variety of lung cancer biopsy methods. Your doctor will talk to you about which might be the best for you.

 A lung cancer biopsy can be done in a number of ways, including during a bronchoscopy (bron-KAHS-cah-pee), in which your doctor examines abnormal areas of your lungs using a tiny camera that’s passed down your throat and into your lungs. Biopsy samples also may be taken from lymph nodes or other areas where cancer has spread (metastasized), such as your liver.

Mediastinoscopy (mee-dee-ah-STIN-ahs-kah-pee) is a procedure to biopsy the lymph nodes. A surgeon makes a small cut (incision) at the base of your neck. Very thin surgical tools are inserted behind your breastbone to take tissue samples from lymph nodes.

In a needle biopsy, your doctor uses X-ray or CT images to guide a very thin needle through your chest wall and into the lung tissue to collect cells.


Many factors are important to consider when you think about treatments for lung cancer, including your age, your overall health and the stage your cancer is in when you are diagnosed. Your doctor will explain the types of treatment they feel are right for you. You may start with treating symptoms such as shortness of breath, before moving into more intensive treatment such as surgery. 

Lung cancer treatment includes:


This treatment for lung cancer uses an intense stream of energy to kill cancer cells. During treatment, you lie still on a table while a machine moves around you, specifically targeting your cancer cells. 


The surgeon will try to remove the lung cancer and keep as much healthy tissue intact as possible. Surgery is an option if your lung cancer hasn’t metastasized (spread to other parts of the body). Sometimes your doctor may recommend chemotherapy or radiation before surgery. The tumor can be shrunk by those treatments, and surgery can remove what’s left behind.

Types of lung cancer surgery include:

  • Segmental resection, which removes a larger part of the lung, but not an entire lobe.
  • Lobectomy removes an entire lobe of one lung.
  • Pneumonectomy (noo-moh-NECK-toh-mee) removes one entire lung.

Norton Cancer Institute participates in national lung cancer clinical trials. Ask your cancer care team if a clinical trial is right for you.


Chemotherapy is an intensive lung cancer treatment medication that can be taken in a pill or via a vein in your arm (intravenously). These powerful medicines kill cancer cells. They are usually given in a series of treatments over weeks or months, with breaks in between to allow you to recover. Chemotherapy often is used with other lung cancer treatments, including surgery and radiation therapy. For people with advanced lung cancer, chemotherapy can relieve pain and other symptoms.            

Targeted drug therapy focuses on specific abnormalities in cancer cells. These drugs kill lung cancer cells and often are used in patients with recurring or advanced lung cancers.

Lifestyle Changes to Prevent Lung Cancer

The No. 1 thing you can do to reduce your risk of developing lung cancer is to not start smoking, or to quit smoking. Ten to 15 years after quitting smoking, your risk of developing lung cancer drops by half. Within five years of quitting smoking, your risk of developing other cancers, such as throat and oral cancers, drops by half. 

Other ways to reduce risk factors of lung cancer:

  • Avoid secondhand smoke and other substances that can harm your lungs.
  • Eat a healthy diet and maintain a weight that’s healthy for you. Some studies suggest that eating fruits and vegetables (two to 6½ cups per day) can help reduce your risk of many kinds of cancer.
  • Have lung cancer screenings if you’re at high risk or have a family history of lung cancer.

A Note on Vaping and Cancer Risk

While electronic cigarettes have significantly fewer harmful chemicals than regular cigarettes, they are not harmless. They still contain nicotine, the addictive substance in cigarettes, as well as potentially harmful cancer-causing substances. According to the Centers for Disease Control and Prevention, because vaping products have not been around very long, studies have been limited. The long-term effects of vaping are still not known.

Risk factors

Besides smoking and secondhand smoke, other causes of lung cancer include:

  • Radiation therapy: If you have already had radiation to the chest for another type of cancer, it can increase your risk of developing lung cancer.
  • Exposure to radon gas: Radon is a naturally occurring gas. It comes from the breakdown of uranium in soil, rock and water. The gas becomes part of the air you breathe. Unsafe levels of radon can accumulate in any building, including homes. 
  • Exposure to asbestos and other carcinogens: Exposure to asbestos and other substances known to cause cancer — such as arsenic, chromium and nickel — can increase your risk of developing lung cancer, especially if you’re a smoker.
  • Family history of lung cancer: If you have a parent, sibling or child with lung cancer, you may have an increased risk of the disease.


Lung cancer can have many complications that range from moderate to severe. 

  • Shortness of breath can happen if the cancer blocks your airways, or if fluid builds up around your lungs. This can make it hard to take in a full breath. 
  • Coughing up blood: Known as hemoptysis (heem-OP-tih-sis), this is caused by bleeding in the airway. Sometimes bleeding can become severe. 
  • Pain from advanced lung cancer can occur if the disease has spread to the lining of a lung or to another area of the body, such as a bone. 
  • Fluid in the chest (pleural effusion) can be caused by lung cancer. This fluid builds up in the space between the lungs and chest wall. 
  • Cancer spreading to other parts of the body such as the brain, bones and organs is known as metastasis.

Depending on where lung cancer has spread (metastasized), it can cause pain, nausea, headaches, or other symptoms depending on what organ is affected. Once lung cancer has spread beyond the lungs, it’s generally not curable. Treatments are available to manage pain, relieve symptoms and to help you live longer.

Lung Cancer Support

Cancer takes a toll on your mental, emotional, and physical well-being. That’s why it is key to have support systems in place. Norton Cancer Institute treats the whole person, from diagnosis and treatment to support groups and complementary therapies. There are classes for patients as well as their caregivers. Cancer support services are offered free of charge to our patients and their families.

Next Steps

Unfortunately, most people don’t experience lung cancer signs right away. In fact, more than 50% of people who have lung cancer aren’t diagnosed until it has spread to other parts of the body, when it is treatable but rarely cured. That’s why early screenings are so important.

If you are experiencing lung cancer signs or are concerned that you are at an increased risk for lung cancer, talk to your physician or call (502) 629-5864 (LUNG) to speak with a patient navigator.

Norton Cancer Institute offers painless, high-speed, low-dose CT lung cancer screenings, which can catch symptoms early — and greatly improve the chance of successful treatment.

Lung Cancer Care for the Whole Person

Our Norton Cancer Institute Comprehensive Lung Center uses a multidisciplinary team approach. Our center allows you to see your oncologist, surgeon, radiation oncologist, counselor, nutritionist and other members of your care team all in one visit. No other facility in town offers the same seamless care. We have four dedicated patient navigators who manage day-to-day details and patient appointments. Specialists include pulmonologists, medical oncologists, radiation oncologists, thoracic surgeons and support services (dieticians, etc.). All our oncologists subspecialize in lung cancer. Our teams attend tumor boards to determine the best plan of care for your specific case. Patients often can get into the clinic within days of a referral to the Comprehensive Lung Center.

We offer state-of-the-art diagnostic tools and treatment techniques, including ultrasound, MRI and biopsies. Biopsies are done with minimally invasive robotic-assisted bronchoscopy. Targeted molecular therapies are used for certain subtypes of lung cancer. Other treatments include immunotherapy and biologic therapies designed specifically to target the genetic makeup of your cancer.

In addition to our current leading-edge treatments, we offer our patients the opportunity to participate in innovative National Cancer Institute- and industry-sponsored clinical research studies.

Five Norton Cancer Institute Resource Centers in Louisville and Southern Indiana offer a variety of support services that address the emotional, physical and spiritual needs of patients and their families. Specially trained oncology nurses also are on hand to provide one-on-one counseling. Patient resources offerings range from wigs to massage/music/art therapy, support groups and the Norton Cancer Institute Sexual Health Program. We take care of not just the body, but the person within.

Norton Cancer Institute is part of the first health system in Kentucky to become a GO2 for Lung Cancer Center of Excellence in both care continuum and screenings. This designation reflects the use of:

  • A patient-centric, collaborative care model that means patients can see an oncologist, surgeon, radiation oncologist, counselor, nutritionist and other members of their care team all in one visit
  • The most effective diagnostic and therapeutic technologies and techniques available

Medicare, Medicaid and most major insurance plans are accepted.

Communicate with your care provider, renew prescriptions, make appointments and get alerted if an earlier appointment becomes available through your free Norton MyChart account.

Norton Cancer Institute has multiple outpatient locations and infusion centers in Louisville, in surrounding counties in Kentucky and in Southern Indiana. We have multiple radiation centers located just off major interstates, with free self-service parking and valet parking.

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