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Lung Cancer Symptoms and Stages

Dear Dr. Dave and Dr. Dee,

My sister quit smoking over 20 years ago and has been in fine health until about a month ago when she started coughing a lot. But, she ignores my insistence that she see a doctor. She says that if she has lung cancer, then she's a goner, so why worry about it. Is coughing a symptom of lung cancer?


Cancer concerns

Dear Cancer concerns,

Early diagnosis and treatment is important in order to stop the progression of cancer, relieve symptoms and live a longer life.

Having lung cancer or any other cancer is not an automatic death sentence. When a diagnosis of lung cancer is made, the severity or stage of the disease progression is identified in order to determine the best treatment options. Described below are the symptoms and staging of lung cancer.

The American Cancer Society ( lists the common symptoms and signs of lung cancer. A doctor should be seen immediately if any of these problems occur.


1. Cough that does not go away

2. Chest pain, often made worse by deep breathing, coughing, or laughing

3. Hoarseness

4. Weight loss and loss of appetite

5. Bloody or rust-colored sputum (spit or phlegm)

6. Shortness of breath

7. Infections such as bronchitis and pneumonia that keep coming back

8. New onset of wheezing

In addition, if the lung cancer has spread to other organs, then symptoms may include:

9. Bone pain

10. Weakness or numbness of the arms or legs

11. Headache, dizziness, or seizure

12. Yellow coloring of the skin and eyes (jaundice)

13. Lumps near the surface of the body, caused by cancer spreading to the skin or to lymph nodes in the neck or above the collarbone


There are two main types of lung cancer: Small Cell and Non-Small Cell. According to the American Cancer Society (, 85 to 95% of lung cancers are Non-Small Cell Lung Cancer (NSCLC). Staging for NSCLC is described below.

Before treatment can begin, the severity or progression of the lung cancer must be determined. There are five stages ranging from 0 to IV (0 to 4) indicating less to more serious cancer.

The 5-year relative survival rate is the percentage of patients who live at least 5 years after being diagnosed with cancer. Some patients can live much longer than 5 years.


Stage 0: lung cancer is limited to the lining layer of air passages and has not invaded deeper into the lung tissue. Curable by surgery, photodynamic therapy, laser surgery, or brachytherapy. 5-Year Relative Survival Rate: 80%

Stage I: lung cancer confined to the lungs and surrounded by normal tissue. Treatment is surgery, either removal of the tumor by lobectomy (taking out one lung lobe) or segmentectomy (taking out part of the lung). 5-Year Relative Survival Rate: 47%

Stage II: lung cancer has spread to nearby lymph nodes. Treatment is surgery by lobectomy followed by chemotherapy and possibly radiation. 5-Year Relative Survival Rate: 26%

Stage III: lung cancer has spread to the chest wall, diaphragm, nearby organs, lymph nodes, or blood vessels. Treatment may include radiation therapy, chemotherapy, surgery or a combination of these. 5-Year Relative Survival Rate: 8%

Stage IV: lung cancer is widespread to distant organs in the body. Treatment may include radiation therapy, chemotherapy, surgery or a combination of these. 5-Year Relative Survival Rate: 2%

For more information about lung cancer, see