Lung Cancer: Symptoms, Diagnosis, and Next Steps

Lung cancer issues?

My husband was diagnosed with malignant liver cancer (stage II) last August.
The tumor pressed against the diaphragm, so a small portion was surgically removed.
Since March of this year, he has been experiencing persistent shortness of breath, occasional fever, coughing, and weight loss.
Initially, we consulted a hepatobiliary and gastroenterology clinic, where the doctor diagnosed him with kidney stones.
After taking medication, he began to experience night sweats and chills.
Two weeks later, he returned to Chang Gung Memorial Hospital to have the previously placed biliary stent removed.
During the endoscopy, signs of a gastric ulcer were observed.
Shortly thereafter, he developed a persistent cough with white sputum and foul-smelling phlegm for unknown reasons.
He then went back to Chang Gung for an X-ray, which revealed air bubbles in his body, suggesting pressure on the lungs, leading to varying levels of respiratory issues.
This has severely affected his sleep at night and has significantly impacted his work and interpersonal relationships.
Today, we consulted a pulmonologist who, after auscultation, suspected either emphysema or lung cancer.
He was prescribed medication and effervescent tablets, but there has been no improvement.
Which specialty should we consult to accurately identify the underlying cause? Thank you for your patience in reading this.

Fang Afei, 30~39 year old female. Ask Date: 2022/04/27

Dr. Hong Yuanbin reply Internal Medicine

Hello, based on your description, it is likely that a weakened immune system has led to a lung infection or inflammation.
Whether there is emphysema or lung cancer requires further examination for confirmation.
Typically, your condition is indeed managed by a pulmonologist; however, if you have a fever, you may also consult an infectious disease specialist.
Thank you for your inquiry.

Reply Date: 2022/04/27

More Info

Understanding lung cancer and its associated symptoms, diagnosis, and next steps is crucial, especially in the context of your husband's recent health challenges. Given the complexity of his medical history, including a malignant liver tumor and subsequent respiratory symptoms, a comprehensive approach is necessary to determine the underlying cause of his current condition.

Symptoms of Lung Cancer
Lung cancer can manifest through various symptoms, which may overlap with other respiratory or systemic conditions. Common symptoms include:
1. Persistent Cough: A new cough that does not go away or a change in a chronic cough.

2. Coughing Up Blood: Hemoptysis, or coughing up blood, can be a significant indicator.

3. Shortness of Breath: Difficulty breathing or wheezing, which may worsen over time.

4. Chest Pain: Pain that may be persistent and worsen with deep breathing, coughing, or laughing.

5. Unexplained Weight Loss: Significant weight loss without trying can be a red flag.

6. Fatigue: Persistent tiredness that does not improve with rest.

7. Recurrent Infections: Frequent respiratory infections, such as bronchitis or pneumonia.

In your husband's case, symptoms such as persistent cough, weight loss, and respiratory distress are concerning and warrant further investigation.

Diagnosis
Diagnosing lung cancer typically involves several steps:
1. Medical History and Physical Examination: A thorough assessment of symptoms, medical history, and a physical exam by a healthcare provider.

2. Imaging Tests: Chest X-rays and CT scans are commonly used to visualize lung abnormalities. In your husband's case, the presence of air bubbles and potential lung compression noted in the X-ray suggests a need for further imaging.

3. Pulmonary Function Tests: These tests assess lung capacity and function, which can help differentiate between conditions like emphysema and lung cancer.

4. Bronchoscopy: This procedure allows direct visualization of the airways and can facilitate biopsy of suspicious lesions.

5. Biopsy: If a mass or nodule is identified, a biopsy is essential to determine whether it is malignant and to identify the type of cancer.

Next Steps
Given the symptoms and the potential for serious underlying conditions, here are the recommended next steps:
1. Referral to a Pulmonologist: Since your husband is experiencing respiratory symptoms, a pulmonologist specializes in lung conditions and can conduct further evaluations, including imaging and possibly a bronchoscopy.

2. Oncologist Consultation: Given his history of malignancy, consulting an oncologist may be beneficial for a comprehensive evaluation of any potential cancer recurrence or new malignancy.

3. Additional Imaging: A CT scan of the chest may provide more detailed information about lung structures and any masses present.

4. Symptom Management: Addressing symptoms such as cough and shortness of breath is essential. Medications, pulmonary rehabilitation, or oxygen therapy may be necessary to improve quality of life.

Conclusion
Your husband's symptoms are concerning and could indicate a serious condition, including lung cancer or complications from his previous liver tumor. It is crucial to pursue a thorough evaluation by a pulmonologist and possibly an oncologist to clarify the diagnosis and determine the appropriate treatment plan. Early detection and intervention can significantly impact outcomes, so timely follow-up is essential. Please ensure that he receives the necessary referrals and evaluations as soon as possible.

Similar Q&A

Understanding Lung Adenocarcinoma: Mechanisms, Symptoms, and Treatment Options

What is lung adenocarcinoma; what is its pathological mechanism; what are its clinical symptoms; and how should it be treated?

Dr. Yang Wenda reply Pulmonology
Hello Mr. Jack: Lung adenocarcinoma is a type of lung cancer classified by its pathological tissue characteristics. The pathological mechanisms, like those of other cancers, are not yet fully understood. Generally, it is most closely related to genetic predisposition and exposure...

Understanding Lung Cancer Symptoms: When to Seek Medical Help

Hello Doctor, I would like to ask about my current symptoms. I have been smoking for about 20 years. A few years ago, I noticed that I was coughing more frequently, and it has continued to the present, becoming quite severe. When I walk up to the fourth floor, I become very short...

Dr. Wang Weijie reply Internal Medicine
Mr. Chen: Hello, the early signs of lung cancer can sometimes manifest as a cough. I recommend that readers seek medical attention at a pulmonology clinic for a chest X-ray examination, which is currently covered by health insurance. Wishing you safety and health. Sincerely, Dr. ...

Understanding Lung Nodules: What You Need to Know and Next Steps

Hello Doctor: My mother underwent a self-paid health examination at Kaohsiung Chang Gung Memorial Hospital two weeks ago. We received the examination report yesterday, which indicated that there is a pulmonary nodule in the lower left lung that requires follow-up examination. Alt...

Dr. Ke Zhengchang reply Pulmonology
There are many causes of pulmonary nodules, which can be benign or malignant. A computed tomography (CT) scan and other examinations are necessary to differentiate between them. If it is not possible to distinguish between benign and malignant nodules, surgical resection or biops...

Monitoring Lung Adenocarcinoma: Key Insights and Next Steps

Dear Dr. Chen, I am a patient with lung adenocarcinoma. On May 21 of this year, I underwent surgery to remove a malignant tumor (2.2 cm) from my right upper lobe and a nodule from the same side lower lobe. The biopsy of the right lower lobe nodule also confirmed malignancy. A PE...

Dr. Chen Yunfang reply Oncology
Hello: Based on the provided information, the reliability and accuracy of the three types of examinations are best with positron emission tomography (PET scan), which is the second option. Both the first option, computed tomography (CT scan), and the third option, magnetic resona...