A special area of the chest wall is formed at the top of the lung, that is, around the apex of the lung. Nerve fibers from the neck that dominate the sensation and movement of the upper limb enter the upper limb through this area. Therefore, if the tumor invades this area, you will often feel the pain and fatigue of the affected upper limb. As a kind of lung cancer, this so-called "Pan-Koster cancer", or superior sulcus cancer, often takes shoulder pain as the main symptom. This kind of pain often needs analgesics to relieve it. Usually, such patients are easily sent to plastic surgeons or neurologists for treatment, thus losing the opportunity of early diagnosis.
Nearly a quarter of the lung surface is adjacent to the so-called "mediastinum". The word "mediastinum" means "the middle part of the chest" and represents a space containing a series of living organs. The mediastinum is located directly behind the sternum and is considered as the "central area" in non-professional fields. The trachea and main bronchus pass through the mediastinum. The esophagus clings to the back of the trachea and extends downward through the trachea. The heart and its great vessels, as well as some great nerves related to life, also pass through this area. If the cancer has invaded the mediastinum, the following symptoms may appear:
● hoarseness is the most common symptom. The recurrent laryngeal nerve, which controls the left pronunciation function, goes down from the neck to the chest, bypasses the great vessels of the heart and goes up to the throat, thus dominating the left side of the pronunciation organ. Therefore, if the tumor invades the left mediastinum and compresses the recurrent laryngeal nerve, there will be hoarseness, but there will be no symptoms of upper respiratory tract infection such as sore throat;
● There is superior vena cava on the right side of mediastinum, which transfuses venous blood of upper limbs and head and neck to the heart. If the tumor invades the right mediastinum and compresses the superior vena cava, it will initially make the jugular vein swell due to poor reflux, and finally lead to edema of the face and neck, which needs timely diagnosis and treatment.
Finally, almost all patients with lung cancer with regional spread have different degrees of shortness of breath. Normal tissue fluid produced by lung and myocardium is refluxed from lymph nodes in the middle of chest. If these lymph nodes are blocked by tumors, these tissue fluids will accumulate in the pericardium to form pericardial effusion or accumulate in the chest cavity to form pleural effusion. Both of the above conditions will lead to shortness of breath. However, because many smokers have different degrees of chronic lung diseases, it is difficult to distinguish shortness of breath. In addition, because some lung tissues lose their respiratory function due to tumors, their respiratory function is impaired, which leads to respiratory discomfort. At first, this kind of discomfort only appears during exercise, and finally it can be felt even during rest.
All the above symptoms suggest that lung cancer is in the advanced stage. Unfortunately, their appearance makes the prognosis relatively poor.