Final stages of lung cancer means when the can has spread to distant sites or organs. The symptoms of final stage lung cancer may be local symptoms due to lung mass or symptoms of distant spread, depending on the site or organ of spread.
Symptoms of Local Spread of Lung Cancer
Chronic cough that does not respond to treatment and gets worse with time may be a sign of lung cancer. It may be dry cough or associated with sputum production, due to underlying infections. Sometimes, it may contain blood.
Pain in the chest
Pain in the chest that gets worse while coughing may be due to lung cancer. A superficial lung mass may involve the parietal pleura covering around the lung, which is pain sensitive.
Irritation or rubbing of the parietal pleura by lung mass, like on deep inspiration or coughing may cause chest pain or discomfort.
Blood in sputum
Blood in sputum or phlegm may be another indicator of lung cancer. It may be blood tinged or grossly red in colour, depending on the amount of blood in sputum.
This usually happens when the lung mass erodes into the airway, and is more common with centrally located lung cancer compared to peripheral ones.
Hoarseness of voice
Sometimes, lung mass may irritate or involve the recurrent laryngeal nerve. This nerve mainly passes through the thoracic cavity and supplies the larynx or voice box. Hoarseness of voice may result from it’s involvement by tumor.
Shortness of breath or difficulty in breathing
A large lung mass that involves a large part of lung may limit it’s capacity to expand effectively. This may cause breathlessness, especially on exertion or activity.
Sometimes, there may be fluid collection in the pleural cavity surrounding the lung (pleura effusion). This may also restrict the expansion leading to this symptom.
Persistent or Recurrent Infections
Persistent infections like bronchitis or pneumonia that do not respond to treatment may be due to lung mass obstruction the airway and causing the lung secretions to stagnate. This may cause superadded bacterial or viral infections that may be difficult to get rid off at times.
Symptoms of lung cancer may also depend upon the size and location of the disease. Large tumors may produce symptoms due to compression of adjacent structures, for example, compression of the esophagus may cause difficulty in swallowing and compression of the superior vena cava may cause facial edema.
Symptoms of Distant Spread of Lung Cancer
Approximately 30% to 40% of NSCLC and 60% of SCLC patients present with metastatic disease. The most common sites of hematogenous spread are CNS, liver, bones and adrenal glands. Diffuse meningeal involvement is uncommon at the time of initial presentation, but it may be seen later in the course of the disease, particularly with SCLC. The lymphatic spread of lung cancer may manifest with cough and dyspnea, depending on the extent of parenchymal involvement
- Bone pain or fractures – if lung cancer has metastasized to bones.
- Jaundice, Fatigue, Nausea, or bloating – if lung cancer has metastasized to the liver.
- Vision issues, severe headaches, or seizures – if lung cancer has metastasized to the brain.
- Cough, breathlessness, and chest pain.
- Loss of appetite.
Lung metastasis are more commonly multiple than single, and bilateral than unilateral.
Some cases are associated with a group of specific symptoms (or syndromes) like Horner syndrome, superior vena cava syndrome, or paraneoplastic syndrome.