Experiencing back pain for two months, along with a recent onset of a dry cough, could raise concerns about various conditions, including lung cancer. However, these symptoms can also be associated with other medical issues. It is important to consult a healthcare professional for a thorough evaluation and appropriate diagnostic tests to determine the underlying cause?
Hello Dr.
Yang: I am a full-time mother, do not smoke or drink alcohol, and rarely use oil for cooking.
There is no family history of lung cancer.
After giving birth to my baby last August, I have been a full-time caregiver at home.
Since recovering from a cold in January, I have started experiencing chest tightness.
I went to a pulmonologist for a chest X-ray, which came back normal.
Concerned, I underwent a full health check-up, including a laryngoscopy that showed no issues and an endoscopy that revealed only mild gastroesophageal reflux.
Blood tests and various tumor markers (AFP/CEA/CA199/SCC/EBV-IgA.CA72-4/cyfra21-1) were all normal.
However, my lung capacity was below the standard (76 < 80).
At the end of January, I began experiencing pain in the right side of my back (inside the shoulder blade), which initially was localized but gradually spread.
The pain has become severe enough to wake me up at night.
I had an X-ray at an orthopedic clinic that showed no issues, and a physical medicine and rehabilitation doctor performed a muscle ultrasound and MRI, which also indicated normal skeletal and muscular conditions, with slight muscle swelling possibly due to overexertion from carrying my child.
I continued taking medication from the rehabilitation doctor, but the pain has not diminished.
As of now, the pain has spread to the left side, and I also experience pain in my arms, chest, and shoulders.
Additionally, over the past two weeks, I have developed a persistent dry cough (without cold symptoms).
I read online that early-stage lung cancer can present with back pain and a dry cough, so I had another chest X-ray, which the doctor said was normal.
I am really afraid that I might have lung cancer because the pain is quite severe! The cough does not occur at night while sleeping, but I do cough during the day.
I feel like I have phlegm, but it is not much, and when I cough it up, it is a white, foamy sputum.
I would like to ask Dr.
Yang if it is still necessary for me to undergo a low-dose CT scan? Is there still a risk of blind spots with the X-ray?
Jessie, 30~39 year old female. Ask Date: 2017/03/16
Dr. Yang Wenda reply Pulmonology
Hello: Your age, recent X-ray examination, and history of exposure to carcinogens are not significant.
You currently belong to a low-risk group for lung cancer.
As for the pain in your upper back, you have already consulted with a rehabilitation specialist.
Please follow the physician's instructions to modify your lifestyle habits and take medications or engage in stretching exercises and other physical therapy as necessary!
Reply Date: 2017/03/16
More Info
Dear Patient,
Thank you for sharing your concerns regarding your symptoms of back pain and coughing, especially in the context of your recent health history. It’s understandable to feel anxious about the possibility of lung cancer, particularly when experiencing new and unexplained symptoms. Let’s break down your situation and address your questions.
Firstly, it’s important to note that back pain and coughing can arise from a variety of causes, and not all of them are related to lung cancer. In your case, you have a history of respiratory symptoms following a cold, and you have undergone several medical evaluations, including X-rays and endoscopies, which have returned normal results. Additionally, your blood tests for tumor markers were also normal, which is reassuring.
Lung cancer can sometimes present with symptoms such as persistent cough, back pain, and shortness of breath, but these symptoms are not exclusive to lung cancer. They can also be caused by conditions such as bronchitis, pneumonia, allergies, or even musculoskeletal issues, especially given your recent physical activities related to caring for your child. The fact that your X-rays and other imaging studies have not indicated any abnormalities is a positive sign.
Regarding your specific questions about the necessity of a low-dose computed tomography (LDCT) scan, it’s essential to weigh the risks and benefits. LDCT is a sensitive imaging modality that can detect lung nodules and other abnormalities that standard X-rays might miss. However, it also exposes you to radiation, and the decision to proceed with this imaging should be based on your risk factors for lung cancer, including age, smoking history, and family history. Given that you are a non-smoker with no family history of lung cancer, your risk appears to be low.
If your symptoms persist or worsen, or if you develop new symptoms such as significant weight loss, persistent cough with blood, or severe shortness of breath, it would be prudent to discuss further imaging options with your healthcare provider. They may recommend an LDCT if they believe it is warranted based on your clinical presentation.
In the meantime, managing your symptoms is crucial. Since you mentioned that the pain has spread and is affecting your daily life, consider discussing pain management strategies with your healthcare provider. Physical therapy, medication, or other interventions may help alleviate your discomfort.
Lastly, it’s important to maintain open communication with your healthcare team. If your anxiety about lung cancer continues to affect your well-being, consider discussing this with your doctor, who may provide additional support or reassurance.
In conclusion, while back pain and coughing can be concerning, your recent evaluations have not indicated lung cancer. Continue to monitor your symptoms, and don’t hesitate to seek further evaluation if needed. Your health and peace of mind are paramount, and your healthcare team is there to support you.
Best wishes for your health and well-being.
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