Not all people with lung cancer experience chronic coughing before being diagnosed, doctors at Changhua Hospital said on Thursday after a 66-year-old man was diagnosed without many of the usual symptoms.
The patient, surnamed Wu (吳), about a year ago reported pain in his neck and while swallowing, but several visits to otolaryngology clinics failed to confirm his suspicion that the symptoms were linked to surgery to remove a benign tumor in his thyroid gland.
As the pain persisted, he booked an appointment with Hsu Chia-fang (許嘉方), director of the otolaryngology department at Changhua Hospital.
Photo courtesy of Changhua Hospital via CNA
An endoscopy showed no problems with Wu’s throat and oral cavity, while no hard lumps could be felt on his neck, but a chest X-ray showed a shadow in the upper part of his right lung, Hsu said.
A computed tomography scan showed a tumor about 5.5cm long, he said.
Wu was transferred to Chang Tzu-yen (張子晏), a pulmonologist at the hospital, who confirmed via a biopsy that Wu had stage 3 lung adenocarcinoma that had not spread to other organs.
Wu, who the doctors said is recovering well after surgery, chemotherapy and radiation therapy, on Thursday returned to the hospital to thank the medical team.
The possibility of lung cancer did not occur to him, as he rarely coughed, did not cough up phlegm, had no chest pains and had quit smoking years earlier, Wu said.
Due to discomfort while swallowing, his appetite waned and his weight dropped from 65kg to 52kg in one year, he said.
The primary symptoms of lung cancer include persistent coughing for more than three weeks, a hoarse voice and lumps in the neck, but Wu had none of these symptoms, Hsu said.
Based on the size of the tumor, it might have been there for a year, he added.
If the cancer cells spread to other organs near the lungs, symptoms such as chest pain, a hoarse voice, difficulty swallowing, heart palpitations and arrhythmia would arise, he said.
However, as Wu’s cancer did not spread, it is unusual that he experienced difficulty swallowing a year ago, he said.
Research shows that only about 65 percent of people with lung cancer experience persistent coughing, so the connection between lung cancer and coughing is not “absolute,” he added.
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