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The most common symptoms of lung cancer are coughing and breathing problems. But you also get these symptoms with many other illnesses that affect this part of your body, such as colds, flu, asthma and bronchitis.

What makes the symptoms different in lung cancer is that they don't get better. They won't be cured by simple remedies that you can buy at the pharmacy or get from your doctor. You may also get much more troubling symptoms, such as coughing up blood.

You shouldn't ignore minor symptoms like coughing and breathlessness, especially if they go on longer that you would usually expect with a cold or chest infection.

If you have lung cancer, you may get symptoms that are caused by the cancer in your lung. And if the cancer has spread, you may get symptoms caused by its effects on your chest or other parts of your body. Many people get both types of symptoms, although usually they get symptoms in the lung first.¹

You may get the following symptoms because of cancer in your lung.

• Coughing: If you have lung cancer, you may get a cough that doesn't go away and gets worse over time. This happens when the cancer stops you from getting enough air into your lungs.
• Shortness of breath or wheezing: This may be due to cold or flu. Or it may happen if you are getting more exercise than you're used to. But it may be a symptom of lung cancer. Again, the cancer is preventing you from getting enough air into your lungs.
• Coughing up blood: This could be just a few spots on a tissue. Or there could be larger amounts. It may be caused by the tumor damaging your lung tissue. If you cough up blood you should see a doctor right away.
• Airway infections: Repeated chest infections, such as bronchitis and pneumonia, can happen when a tumor starts to block your airways. Fluid in your lungs becomes trapped and infected.
• Fever: Lung cancer can cause fever and a rise in body temperature.

If the cancer spreads to the lining of your lung, you may get:

• Chest pain. You can get this with other conditions, such as indigestion and angina (chest pain caused by narrowing of blood vessels near your heart). But with lung cancer, the pain doesn't go away.

If the cancer spreads to other parts of your chest, you may get these symptoms.

• Hoarseness when you speak: A tumor in your left lung could spread into the middle of your chest. When this happens, the nerve that goes to your voice box may be damaged. This can cause hoarseness.
• Swallowing problems: This can happen if a tumor grows near the tube (esophagus) that carries food from your mouth to your stomach.

Cancer that spreads outside your chest can cause these symptoms.

• Pain in your arms, legs or back: As well as spreading to other parts of your chest, lung cancer can spread to your bones. This may cause stiffness, aching or tingling in your arms, legs or back.
• Confusion, forgetfulness and other problems: Cancer that has spread to your brain may cause different physical or emotional symptoms. What symptoms you get depends on which part of the brain is affected.

Do bear in mind that everyone gets aches and pains from time to time, whether or not they have lung cancer. It's natural to worry that a new pain means your cancer is spreading, but it may be due to something completely different. If you're anxious, be sure to tell your doctor or nurse, so that you can have tests to check it out.

You may:

• Lose your appetite
• Lose weight
• Feel weak
• Feel tired.

These symptoms happen because cancer cells divide and grow much faster than normal cells. They "steal" more than their fair share of the nourishment you get from your food, leaving your normal body cells without enough. It's a vicious circle because the more tired you get, the less you feel like eating, and the weaker you feel.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.