The majority of patients who are diagnosed with lung cancer usually present with locally advanced or metastatic disease. Only about one third of patients have stage I disease when diagnosed. The symptoms that the patient exhibits usually reflect the extent of the cancer's spread. Lung cancers that are discovered early may cause symptoms localized to the respiratory system. However, lung cancer that is advanced will cause patients to experience additional signs and symptoms secondary to the cancer spreading to other organ systems. In order of highest frequency, the most common signs of lung cancer include: * cough that does not go away or gets worse * weight loss * dyspnea (shortness of breath or difficulty breathing) * chest pain, which may be aggravated by deep breathing, coughing, or laughing * hemoptysis (coughing up blood or rust-colored phlegm) * bone pain * clubbing * fever * generally feeling tired or weak * superior vena cava obstruction- facial, neck, upper torso swelling. This is caused by compression of vasculature by the lung tumor that restricts blood return from the upper body. * dysphagia (trouble swallowing or the sensation that something is caught in the throat) and hoarseness * new onset of wheezing without history of asthma Clinicians should have a high level of suspicion for lung cancer, especially in patients with a smoking history. Patients with recurring or unresolving lung infections (e.g. bronchitis and pneumonia) that are unresponsive to antibiotics should also be further evaluated for lung cancer. In nonsmokers, women and East Asians are more likely to present with symptoms of an underlying lung cancer at younger ages. Importantly, many of these signs are commonly due to other causes that are not cancer. A detailed medical history should be obtained from each patient to determine the relevance of further diagnostic workup and management. Extrapulmonary manifestations<unk> , like other forms of lung cancer, is usually advanced or metastatic at time of diagnosis. Patients may complain of signs or symptoms outside of the respiratory tract that represent a hematologic or metabolic complication of the malignancy without, however, resulting necessarily from obstruction or metastasis. These go under the name of paraneoplastic syndromes, which often indicate advanced disease and worse prognosis. The most common paraneoplastic syndromes associated with<unk>  are described below: * Hypercalcemia of malignancy is more common in squamous cell carcinoma of the lung, but can occur in<unk>  as well. Parathyroid hormone-related peptide (PTHrP) is produced by tumor cells and functions similarly to parathyroid hormone (PTH). The production of this hormonally active peptide by cancer cells causes increased bone resorption via upregulation of osteoclasts, one of the cells responsible for bone remodeling. When bone is broken down, calcium is released into the bloodstream, resulting in hypercalcemia. The signs and symptoms of elevated calcium in the blood include: thirst, fatigue, constipation, polyuria (increased urination), and nausea. It is important to rule out boney metastases in patients with NSCLC because they also present with hypercalcemia. * Hypertrophic pulmonary osteoarthropathy (HPO) is fairly rare in<unk> . Less than 1% of patients with<unk>  will exhibit this finding, but when it does occur, it is a poor prognostic factor. The exact mechanism of HPO is unknown but it thought to be hormonal or neurogenic in etiology. The triad of HPO includes distal clubbing, arthritis, and bilateral symmetrical periosteal formation.
Adenocarcinoma of the lung
Giant-cell carcinoma of the lung
Sarcomatoid carcinoma of the lung
Acinic cell carcinoma of the lung
Squamous-cell carcinoma of the lung
Non-small-cell lung carcinoma
Pulmonary sclerosing pneumocytoma
Epithelial-myoepithelial carcinoma of the lung