Tag Archive for: lung cancer symptoms

Advice for Managing Lung Cancer Symptoms and Treatment Side Effects

Advice for Managing Lung Cancer Symptoms and Treatment Side Effects from Patient Empowerment Network on Vimeo.

Lung cancer expert Dr. Jyoti Patel explains common symptoms and treatment side effects, and discusses how treatment approaches may vary depending on treatment goals for each patient.

Jyoti Patel, MD, is Medical Director of Thoracic Oncology and Assistant Director for Clinical Research at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. She is also Associate Vice-Chair for Clinical Research and a Professor in the Division of Hematology and Oncology at Northwestern University Feinberg School of Medicine. Dr. Patel is a leader in thoracic oncology, focusing her efforts on the development and evaluation of novel molecular markers and therapeutics in patients battling non-small cell lung cancer. Learn more about Dr. Patel.

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Symptoms and side effects can sometimes be a burden to patients undergoing treatment. What are the most common issues that patients face? 

Dr. Patel:

So, common symptoms from treatment can include fatigue, lack of appetite, disinterest in the things that made you really excited before. Infrequently now we have severe nausea, because we have such good antinausea medications.  

Sometimes we’ll have problems with blood counts or risks of infection. All of these vary by the treatment that’s rendered. And so, often it may be that you’re on a targeted therapy.  

Some targeted therapies, for example, can cause swelling in your legs. Immunotherapies are generally well-tolerated but can cause significant side effects in a small minority of people that could include inflammation in the gut, for example.  

So, everything is sort of tailored, I would say. Most frequently, I hear about the fatigue, and then the ongoing stressors of living with cancer. So, the financial toxicity certainly. These drugs are expensive. But not only that, often people have changed the way they work. Their family members have changed how they work to support their loved one. So, bringing people to appointments.  

There’s a lot on someone’s plate. And that can contribute to fatigue and even some anxiety.  


Yeah. What strategies are in place to manage symptoms and side effects? 

Dr. Patel:

So, having a patient who’s knowledgeable about potential side effects and a good advocate for themselves is probably the best way to manage therapy. So, ongoing dialogue with your clinical team, with your nurse, with your physician, are absolutely important. But most of us work with teams of healthcare workers. And so, when I think about our clinic, we have financial counselors, we have social workers, we have dieticians and nutritionists, we work with physical therapists. And importantly, we work with a palliative care team that helps us, again, manage some of the toxicities of therapy.  

We think that they provide a longitudinal assessment of patients and remember what’s most important to a patient over time. Whereas often in the moment there’s this, we want to make the tumor shrink. We think about what we can do immediately. It’s often really helpful to have another team that can provide support over the patient’s journey to help us, again, prioritize what they wanted to do the most.  


Mm-hmm. Dr. Patel, why do you think it’s necessary for patients to tell their doctor about any issues they may be having? Even the little ones.  

Dr. Patel:

I think most of us want to be good patients. And so, we minimize things because we think that, okay, we’re using precious time to talk about things that may seem minor. But, again, all of these add up.  

Even minor symptoms, particularly in the era of immunotherapy, can turn out to be big problems. So, as I say now to my patients particularly on immunotherapy, if something seems a little bit off and you can’t put your finger on it, I just need to know so I can at least do the appropriate workup to make sure that we’re not missing anything. Because symptoms of underlying problems can be very misleading.  

Moreover, I think the cumulative burden of cancer. So, again, we talked a little bit about the financial toxicity, the emotional cost, the time involved in treatment, all of that adds up. And you never want to get it to a breaking point. We want to manage it early on, so we can, again, make decisions together and keep wellness and the quality of survival at the forefront.  

Lung Cancer and Shoulder Pain

Editor’s Note: This resource, Lung Cancer and Shoulder Pain, was originally published by MyHealthTeam.

There are many causes of shoulder pain. In some cases, it could be the sign of an orthopedic condition (for example, a rotator cuff injury). But shoulder pain is also a possible indicator of lung cancer, according to experts at the Moffitt Cancer Center.

If you are experiencing long-term shoulder pain, you may want to consider if you have any others symptoms that could be associated with lung cancer. Other common symptoms include respiratory issues (hoarseness, coughing up blood, and shortness of breath) and irregular head, back, or chest pain. Even if you don’t have other symptoms, you should nevertheless reach out to a medical professional if you have shoulder pain that persists for longer than a few days.

What Causes Shoulder Pain in Lung Cancer?

As lung cancer progresses, two possible developments may produce shoulder pain: lung tumors and malignant pleural mesothelioma (MPM).

Lung Tumors

When a lung tumor grows in size, it begins to compete for space against the surrounding bones, tissues, and nerves. Pain may develop depending on the tumor’s location and the pressure it is exerting. If a particular nerve is compressed, your body can signal the presence of the lung tumor through referred shoulder pain. You can think about this shoulder pain as an alarm signaling something irregular happening in the body.

Pancoast Tumor

Although it only occurs in 3 percent to 5 percent of all cases of lung cancer, a Pancoast tumor (also called a superior sulcus tumor) is a rare form of non-small cell lung cancer that originates at the topmost part of the lungs. Pancoast tumors usually do not cause respiratory issues typical of other lung cancers. Instead, they expand upward from the top of the lung and begin to hinder the nerves around the shoulders and shoulder blades, causing sharp shoulder pain, among other symptoms. Depending on the Pancoast tumor location, different areas can experience pain.

About 25 percent of people with Pancoast tumors experience a set of conditions referred to as Pancoast syndrome. As the Pancoast tumor continues to enlarge, more of the surrounding nerves become impaired, which may cause disruptions in the sympathetic nervous system (in the case of lung cancer, second-order neurons). This nerve damage can also result in Horner’s syndrome — a condition that can cause decreased pupil size, drooping eyelids, and an inability to sweat. Typically, these symptoms appear on only one side of the face.

Malignant Pleural Mesothelioma

In one study, researchers found that 14.3 percent of people diagnosed with MPM — a form of cancer caused by exposure to asbestos — cited shoulder pain as their first symptom. MPM attacks the pleura (lining of the lungs) rather than the structure of the lung itself. As tumors develop on the pleura, they begin to apply pressure on the chest cavity that can cause pain in the shoulders.

Metastatic Lung Cancer

In people with metastatic lung cancer (advanced lung cancer), the cancer cells from the primary tumor spread out toward neighboring parts of the body. In most cases, lung cancer cells enter the surrounding bones in a process called bone metastasis. As cancer cells begin to invade the bone, they alter its structure. Small holes, called lytic lesions, then develop on the affected bones, which can cause severe pain in the shoulders, back, and chest.

Most of the physical symptoms of lung cancer do not surface until the tumor metastasizes. However, researchers are working every day to find new methods of early detection. By better understanding the causal link between lung cancer and shoulder pain, it may be possible to discover lung cancer in its early stages.

What Does Shoulder Pain in Lung Cancer Feel Like?

Because lung cancer tumors manifest in many different forms and locations, it is difficult to put a general description on the shoulder pain caused by lung cancer. It’s similar in intensity to the pain caused by a condition like arthritis, but there are a few differentiating characteristics.

In most cases, shoulder pain in lung cancer is more prevalent when a person is lying down or resting. It doesn’t typically inhibit movement in the arms as arthritis can. Some people have also noted that they experience a tingling sensation racing down their arms alongside shoulder pain, signifying nerve involvement.

Managing Shoulder Pain With Lung Cancer

Managing symptoms like shoulder pain often starts with treating the lung cancer itself. If this does not relieve your acute pain, your oncologist or health care team may recommend other options (such as over-the-counter or prescription pain relievers).

As with any new or worsened symptoms, contact your health care team if you start experiencing shoulder pain. Make sure to reach out if this pain is causing sleep disruptions or hindering your everyday life.

Treating Lung Cancer

Treating the underlying cancer may help manage symptoms like shoulder pain. One member of MyLungCancerTeam says that they “had a lot of shoulder, arm, and between-the-shoulder pain” right before their diagnosis but added, “after chemo, it went away.” In the case of an intruding lung tumor, for example, once it diminishes in size, the pressure it was applying on the surrounding nerves will go away as well.

The type of lung cancer treatment an oncology specialist recommends depends on the stage and the type of lung cancer you have. In the early stages of lung cancer, it may be possible to remove the tumor surgically. If the tumor has begun to spread, your doctors may suggest chemotherapy or radiation therapy sessions.

Pain Management

There are several methods of alleviating shoulder pain during treatment to help you manage discomfort in day-to-day life.

Medication for Pain Relief

Over-the-counter pain relievers, like nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, may help mitigate mild or moderate shoulder pain caused by lung cancer. Talk with your health care team to understand what pain relief medications you can take with your cancer treatment.

For more severe shoulder pain, your doctor may prescribe stronger medications, including morphine or other opioids.

Hot and Cold Treatments

Ice therapy is mainly used to treat swelling and inflammation, and heat therapy reduces tension and increases flexibility. If your shoulder pain arrives immediately without warning, try to use cold therapy. Penn Medicine recommends applying ice for 15 minutes and then leaving the area bare for another 15 minutes. If the pain continues for longer than 72 hours, try to apply heat. Another member of MyLungCancerTeam rests “with heat on their shoulder.”

Meet Your Team

Living with lung cancer can be a challenge — but you’re not alone. There are others experiencing life with lung cancer who are here to support you. MyLungCancerTeam is the social network for people with lung cancer and their loved ones. Here, you can ask questions, share advice, and learn about the experiences of those managing day-to-day life with their diagnosis.

Have you experienced shoulder pain during your diagnosis? How have you learned to manage it? Share your story by posting on MyLungCancerTeam.

Stage IV Metastatic NSCLC Shares Key Learnings on Her Journey

Stage IV Metastatic NSCLC Shares Key Learnings on Her Journey from Patient Empowerment Network on Vimeo.

Lung cancer patient Carol shares her journey with stage IV metastatic non-small cell lung cancer (NSCLC). Watch as she discusses the symptoms she experienced, how she pushed when her symptoms were dismissed, and key learnings that empowered her on her journey.

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My name is Carol, and I was diagnosed with stage IV metastatic  non-small cell lung cancer (NSCLC) at the age of 53. My initial symptoms were dismissed, but I advocated for myself to receive an accurate diagnosis.

My lung cancer journey began in an emergency room right after New Year’s Day 2022 with severe headache symptoms of head pressure, pain, and vomiting. I knew it was not a normal headache. The ER team started to treat me for a migraine and wanted to send me home. I pushed back and explained that I’d been experiencing symptoms of fatigue, frequent headaches, dizziness, and a weird buzzing sound in my ear over the last few months. I knew that I didn’t feel right and insisted on getting a brain scan.

After waiting hours to get in for the brain scan, they were shocked to find 10 brain metastases. Then a PET scan uncovered the root cause – a tumor in my lung and multiple metastases throughout my body, including leptomeningeal disease. Back when I started having symptoms, I tried to book an appointment with a neurologist, but there wasn’t an opening until February. I shudder to think what would have happened if I had left the ER on January 3 to wait until February. We know our bodies best and need to make sure we push for answers when we know there’s something more to the story. This pushing can be uncomfortable, because no one wants to be labeled “a difficult patient”, but it’s our health – and sometimes our life – at stake.

Following my diagnosis, I received one round of chemo until my genetic testing came back with the EGFR exon 19 deletion result. Then I was switched to a more targeted medication and still receive monthly infusions for bone mets.

Physically my treatment allows me to live an almost normal life enjoying my previous activities of golfing, hiking, and  gardening. And I’ve been surprised by my mental strength and positivity in the face of this horrible disease. Sure… I have times when helpless or sad or angry feelings come up, and I need to embrace and FEEL them, but overall I feel thankful and hopeful.

Some things I’ve learned during my lung cancer journey include:          

  • If something doesn’t feel right with your health, speak up and don’t stop pushing until you get answers.
  • Pay attention to your body when you experience multiple symptoms.
  • Focusing on helping others is another way to take your mind off of your own worries.
  • My friends and family are a big source of emotional support, and we are all going through this cancer journey together. So, I find that it helps them to feel useful when I give them small tasks to do, so they feel like an active part of this journey.

These actions are key to staying on your path to empowerment.

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