Advanced lung cancer means that the cancer has spread from where it started in the lung.
It might not mean that you have advanced cancer if you have the symptoms described below. They can be caused by other conditions.
The most common symptom is feeling tired and unwell.
You might also have:
- a cough that doesn’t go away
- a change in a cough you have had for a long time
- unexplained weight loss
- ongoing chest infections
- coughing up blood
- a hoarse voice
- difficulty swallowing
- changes in the shape of your fingers and nails called finger clubbing
- swelling of the face caused by a blockage of a main blood vessel (superior vena cava obstruction)
- loss of appetite
Your doctor might carry out routine blood tests and find that you have a raised platelet count (thrombocytosis). This might be a sign of lung cancer but could also be due to other illnesses or conditions.
Lung cancer can also sometimes cause a build up of fluid between the chest wall and the lung (a pleural effusion). This can cause a cough and breathlessness.
You may feel very breathless if the cancer is blocking your airway or if there is fluid around your lung.
Where cancer can spread
Other symptoms of advanced cancer depend on where the cancer is in the body. Lung cancer can spread to:
- the lymph nodes within the chest, or in the tummy (abdomen), neck, or armpit
- the brain
- the liver
- the bones
- the adrenal glands
- other parts of the lung or the other lung
Symptoms if cancer has spread to your lymph nodes
Lymph nodes are part of a system of tubes and glands in the body that filters body fluid and fights infection.
The most common symptom if cancer has spread to the lymph nodes is that they are usually bigger than normal. But lymph nodes also get bigger if you have an infection. So you can't be sure of the cause of a lump until your doctor has examined you and done some tests.
Tell you doctor if you find any lumps or swollen areas, particularly in your neck or armpits.
Symptoms of cancer that has spread to the brain
Cancer that has spread to the brain might cause any of the following symptoms:
- drowsiness and confusion
- severe headaches, often with sickness
- weakness of an arm or leg
Symptoms if cancer has spread to the liver
You might have any of the following symptoms if your cancer has spread to the liver:
- discomfort or pain on the right side of your tummy (abdomen)
- feeling sick
- poor appetite and weight loss
- a swollen tummy (called ascites)
- yellowing of the skin and whites of the eyes (jaundice)
- itchy skin
Symptoms of cancer that has spread to the bone
Cancer that has spread to the bone can cause:
- pain (this can be lower back pain if the cancer cells are in the spinal bones)
- weaker bones (they may get damaged or break more easily)
- raised calcium levels in your blood (causing dehydration and confusion)
If you have these symptoms you may have x-rays or an MRI scan or a bone scan.
If cancer cells in the spinal bones are pressing on the spinal cord (spinal cord compression) it can cause:
- weakness in your legs
- loss of bladder or bowel control
Symptoms if the cancer has spread to the adrenal glands
The adrenal glands are small glands just above the kidney.
Cancer that has spread to the adrenal glands doesn’t usually cause any symptoms.
The adrenal glands produce hormones and if cancer has spread to both adrenal glands you might have low levels of adrenal hormones. This might cause:
- tiredness (fatigue)
- unexplained weight loss
Some people might also have stomach ache.
Other rare symptoms
Some people have swollen fingers and nails, and pain and swelling in their joints. This condition is called hypertrophic pulmonary osteoarthropathy (HPOA).
Treatments such as radiotherapy or chemotherapy can sometimes shrink the cancer and reduce symptoms.
Symptom control team
There are symptom control teams in most cancer units. They can help you to stay as well as possible for as long as possible. They are also in hospices and many general hospitals.
Most symptom control teams have home care services so they can visit you at home.