| Lung cancer is the most lethal of malignant | | | | pleura, and mediastinum leads to chest pain as an |
| diseases worldwide and is still the leading cause of | | | | initial symptom or complaint in 25-50% of patients. |
| cancer related deaths in the USA. Although the | | | | Other causes of pain include postobstructive |
| overall deaths in Western Europe and United | | | | pneumonitis, pulmonary embolism, and rib cage |
| Stated have decreased since 1991, global lung | | | | metastases. |
| cancer rates are expected to rise because of | | | | 5-8% of lung cancer patients experience |
| ongoing tobacco use. | | | | hoarseness which is usually attributable to unilateral |
| For the majority of the time lung cancer is | | | | left vocalparalysis resulting from damage to the |
| clinically silent because they grow from a single | | | | left recurrent laryngeal nerve anywhere along its |
| malignantcell to a potentially detectable lesion. The | | | | intrathoracic course. |
| majority of people already have the symptoms | | | | Physical exam is a vital component of the lung |
| of lung cancer at the time of diagnosis. In only | | | | cancer evaluation as it may provide important |
| about 10% of cases is lung cancer discovered | | | | prognostic, diagnostic, and staging clues. The |
| incidentally in an asymptomatic patient. | | | | outside appearance may look normal or it may |
| One of the first symptoms of lung cancer is | | | | reveal debilitation, cachexia, lethargy, pallor, |
| cough, which occurs in 45-75% of patients. | | | | jaundice, fever, or significant comorbidities. Blood |
| Cancer types with a predilection for central | | | | pressure irregularities can be seen in conjunction |
| airway involvement may cause cough earlier in | | | | with neurologic or adrenal paraneoplastic |
| their course. But peripherally located tumors may | | | | phenomena. |
| only cause cough as a late symptom. A change in | | | | A thorough nervous system examination is crucial, |
| the character of a chronic cough, such as new | | | | especially in patients with headache, sensorimotor |
| hemoptysis or co-existent chills and fever, should | | | | complaints, and back pain. Unilateral lower |
| raise suspicion of an additional process such as | | | | extremity swelling, tenderness, and erythema |
| lung cancer. | | | | may accompany deep venous thromboses. |
| Tumor involvement of the chest wall, parietal | | | | |