Fao Sqad

[mrs_overall]

Hi your Sqadness. Can I give you a set of symptoms for your opinion please?
Male, 50, alcoholic, chain smoker of roll-ups, long standing femoral occlusion, develops a hacking cough 3 months ago, loses 4 stone in weight, develops pain in right shoulder and pain in chest. Loses use of right hand (unable to grip anything).
Can this be anything other than lung cancer?

[boxtops]

I'm not sqad, but sorry to hear this - I hope he's seen the doc, the latest campaign suggests you see the doc if a cough goes on longer than three weeks.

[Sqad]

Well yes it can, but i can't think of a more likely diagnosis Mrs_O.

Google Pancoast tumour and .....bingo!

[mrs_overall]

Sqad, the symptoms seem to be that of a Pancoast tumour. Not a bad diagnosis for an ex (head) hospital porter xx

[Sqad]

Mrs_O....if i hadn't spent so much time satisfying the needs of numerous women and studied instead, I could have been a doctor.
But as head porter, I had a lot of perks e.g backhanders from the undertakers, that i thought i would stay as head porter.

Never regretted it.

[Sqad]

\\\develops a hacking cough 3 months ago, loses 4 stone in weight, develops pain in right shoulder and pain in chest. Loses use of right hand (unable to grip anything). \\\\

If and a big if, these symptoms are due to lung cancer, wherever in the lung, then they indicate a marked degree of spread and should well be seen on routine chest X-Ray.

Yes ,I do agree with slaney that at the onset of growth, an apical cancer may be difficult to spot............but these symptoms would suggest that we are not dealing with an early cancer.

[slaney]

I disagree Sqad; it all depends on the direction of growth of the tumour.
Yes, it can be more readily picked up on CXR if it grows downwards into the chest, but classically with a Pancoast tumour growth is into the chest wall structures rather than the underlying lung, so even a fairly advanced tumour may not be easily seen on plain chest X-ray.