Weirdest Lung Cancer Symptoms and How to Manage Them

The lung cancer symptom most often reported in the media is a worsening cough, sometimes along with a handkerchief splattered with blood. But some seemingly unusual symptoms, such as clubbed fingers and shoulder pain, are also common. They may even be early warning signs of lung cancer. Knowing what to look out for may help catch lung cancer earlier, when it's in more treatable and beatable stages.

Syracuse, New York-based author Eugenia Mancini Horan, now 53, lost a significant amount of weight before she was diagnosed with advanced lung cancer in 2019. Her doctor was quick to write this off as anxiety, but Horan, the author of The Dead Girl's Guide to Terminal Cancer, knew something was off and pushed for more tests. "They ordered blood tests to ease my mind, and I thanked them," she says. Rapid and unplanned weight loss occurs when cancer cells release inflammatory substances. Those substances speed up your metabolism and break down muscle and fat. Cancer treatment can also cause loss of appetite and weight loss, but these symptoms go away once the cancer is reined in.

Alisa Secaida, now 40, of La Verne, California, never thought she had cancer, let alone stage IV lung cancer, when she started having sharp, shooting shoulder pain in November 2021, just shy of her 36th birthday. She did have a cough and fatigue, but nothing dramatic. Her primary care doctor chalked these symptoms up to long COVID-19 or allergies. Further testing revealed lung cancer that had spread to lymph nodes near her collarbone and was pushing on nerves, resulting in the shoulder pain. "Once we started getting the cancer under control, the pain decreased," she says.

Changes in the appearance of your fingers, such as swollen, bulbous fingertips or spoon-shaped fingernails, can be an early sign of lung cancer, explains Maria A. Velez, MD, MS, a clinical instructor in the Division of Hematology-Oncology at the UCLA David Geffen School of Medicine in Los Angeles. It's actually fairly common," she says. The cancer releases growth factors that can cause blood vessels to develop in your fingertips, resulting in the clubbing. If you place your index fingernails together, you should see a small diamond-shaped gap. If not, it could suggest clubbing. Your doctor may suggest follow-up testing if you develop clubbed fingers.

A drooping eyelid, often with a change in pupil size, is known as Horner syndrome. "It occurs when a tumor at the very top of your lung affects nerves that travel to your eye and face," Velez says. "The eyelid doesn't open completely, and the pupil becomes smaller." Treating the cancer will usually address this weird lung cancer symptom.

Swelling on one part of your face or neck, also known as superior vena cava syndrome (SVCS), can happen when a lung tumor blocks the superior vena cava – the main vein carrying blood from your head, neck, and arms to the heart. "The tumor presses on the vein, and blood pools and generates backflow that causes swelling," Velez says. This can be a sign of advanced lung cancer. Treating the cancer often eases the swelling, but doctors can also prop open the vein to restore blood flow and ease swelling.

If your lung tumor affects the lymph nodes in your lung, it can press on the laryngeal nerve that controls your voice box. "Your larynx [voice box] is fine, but the pressure causes hoarseness or voice changes," Velez says. Shrinking the tumor – through surgery, radiotherapy, or chemotherapy – can reverse these changes. Resting your voice, getting lots of fluids, running a humidifiers, and sometimes voice therapy may also help.

Some lung cancers cause a buildup of calcium in the blood because the tumor produces a hormone that mimics the body’s own hormone for regulating calcium levels. Low sodium levels can also be a sign of lung cancer if the tumors produce excess amounts of a hormone called antidiuretic hormone (ADH), which can cause sodium levels to dip too low. "This is a phenomenon called paraneoplastic syndromes," says Emily C. Daugherty, MD, an associate professor of radiation oncology at the University of Cincinnati Cancer Center and a thoracic radiation oncologist at the UCCC Lung Cancer Center in Ohio. After the cancer is treated, the bloodwork should return to normal.

New vision changes, confusion, or headaches may suggest that lung cancer has spread to the brain in people at higher risk, Daugherty says. "This should be evaluated urgently," she says. As with other symptoms, treating the lung cancer usually resolves the confusion and other neurologic changes.

Lung cancer does not always look the way it does in the movies. Trust your gut if you are worried about any potential lung cancer symptoms. If your doctor isn't taking you seriously or is writing it off as anxiety or another condition, see a different doctor, Secaida says. Horan agrees: "Be your own advocate." Listen to your body. If you are tired, rest up, they urge.