Certain types of lung cancers are more likely to be found near the center of the lungs. Examples include squamous cell carcinoma, bronchogenic carcinoma, typical bronchial carcinoid and small cell carcinoma. Diagnosis is made by taking tissue samples. People may present to the physician's office complaining of various symptoms.
Generalized Systemic Symptoms
Central lung cancers, along with many other cancers, cause generalized problems in the body. Common systemic symptoms from lung cancer include weight loss, anorexia, loss of appetite and fatigue. (See Reference 1 and 2)
Symptoms from Tumor Spreading in the Chest
The chest has many structures and organs that can be affected by the spread of cancer. If the cancer invades a nerve called the recurrent laryngeal nerve, a person can develop a hoarse voice. It can also invade the phrenic nerve, leading to difficulty contracting the diaphragm, the main muscle used for inhalation. The tumor can compress or invade the esophagus, making swallowing difficult. The large blood vessels are also in the middle of the chest, and the tumor can compress them impairing blood flow to the heart or lungs. It may also invade the chest wall or cause fluid to build up between the chest wall and the lungs. (See Reference 1 and 2)
Symptoms from Tumor Spreading Outside the Chest
Central type lung cancers can also migrate, or metastasize, outside the chest. If they metastasize to bone, they can cause bone pain and fractures. If they metastasize to the brain, they may cause confusion, coma, personality changes, paralysis or numbness in various parts of the body, seizures, headache--particularly when lying down flat--and vomiting. Spread to the liver, kidney or adrenal glands will compromised their functions, leading to fluid imbalances with leg swelling and blood pressure swings for example. (See Reference 1 and 2)
Syndromes and Symptoms Associated with Lung Cancers
Symptoms and syndromes may be caused by the lung cancer but not from direct tumor invasion. For example, the tumor can produce factors that changes bodily functions. Squamous cell lung cancer can cause high calcium levels in the blood by destroying bone directly from metastases or indirectly by producing a hormone similar to parathyroid hormone. High calcium levels manifest with excitable nerves. The skeletal muscles will contract too easily and the high calcium may also cause heart rhythm problems. Lung cancers can also make a hormone like ADH, which acts on the kidneys to conserve water and concentrate urine. Carcinoid tumors may express serotonin, causing skin flushing, diarrhea, wheezing and heart problems. (See Reference 1, 2 and 3)
References
- "Robbins & Cotran Pathologic Basis of Disease"; Vinay Kumar et al; 8th Ed 2009
- American Family Physician: Lung Cancer Diagnosis and Management
- Merck: Paraneoplastic Syndromes
