What Are the Symptoms of Lung Cancer in Women?

Nurse listening to woman's heart with stethoscope
What are the symptoms of lung cancer in women and how do they differ from those in men?. Hero Images/Getty Images

The symptoms of lung cancer in women can differ from symptoms of lung cancer in men. At first that may seem surprising, but just as we've learned that the symptoms of heart disease in women often differ from those of men, the same is true with lung cancer. Sadly, as with heart disease, some of these symptoms are less recognized, and because of this the diagnosis may be delayed.

How Are Lung Cancer Symptoms Different in Women?

The symptoms of lung cancer most people are most familiar with include a chronic cough and perhaps coughing up blood.

With women, the early symptoms of lung cancer are often more subtle or vague. Symptoms may be subtle, such as shortness of breath with activity. This can easily be dismissed as stemming from age, or perhaps that extra 15 pounds you have gained. The symptoms are often also more vague, like general fatigue or just not feeling as good as normal. What are some common symptoms and why would they be different than lung cancer symptoms in men?

Why Might Symptoms of Lung Cancer in Women Be Different Than Symptoms of Lung Cancer in Men?

One of the reasons that symptoms can differ between the sexes is that the most common types of lung cancer vary between the sexes—and different types of lung cancer tend to have different symptoms.

Another reason is that more non-smoking women than men develop lung cancer. The most common types of lung cancer found in non-smokers are also often different than the most common types found in people who smoke.

Symptoms Related to Lung Cancer Type

Non-Small Cell Lung Cancers

Non-small cell lung cancers account for roughly 80 percent of lung cancers. There are three main types of non-small cell lung cancers:

In men, squamous cell carcinoma of the lungs is more common.

Squamous cell carcinomas tend to grow centrally in or near the major airways and often create symptoms early on in the disease. These symptoms may include a chronic cough, coughing up blood, and infections (such as pneumonia) or lung collapse (atelectasis) due to obstruction of the airways by the tumor.

In contrast, the most common type of lung cancer in women is adenocarcinoma. Lung adenocarcinomas tend to grow in the outer regions of the lungs. These tumors can grow quite large or spread before they cause any symptoms. Initial symptoms in women may include:

  • Shortness of breath – The gradual onset of shortness of breath may first be dismissed as being due to age or inactivity. Women may know notice that they become short of breath when they walk up and down stairs or run to the mailbox.
  • Back and shoulder pain – due to pressure on nerves caused by the tumor
  • Chest pain that worsens with a deep breath (pleuritic chest pain) – Tumors near the outer regions of the lungs can irritate the membranes that line the lungs. This can cause pain with breathing.

Small Cell Lung Cancers

The vast majority of small cell lung cancers are related to smoking, and small cell lung cancers occur more often in men than in women. Small cell lung cancers usually begin near the large airways and spread early, often to the brain.

More About Symptoms Related to Smoking Status

One form of non-small cell lung cancer is seen more commonly in young women and people who have never smoked. Bronchioloalveolar Carcinoma (BAC) – a form of lung cancer that has now been reclassified as a subtype of lung adenocarcinoma - may present with symptoms similar to other lung cancers, but it has also been coined the “masquerader.” It is not uncommon for BAC to be misdiagnosed first as pneumonia or other lung diseases. For unknown reasons, the incidence of BAC appears to be increasing.

Common Symptoms of Lung Cancer in Both Sexes

It is helpful to review common symptoms of lung cancer that are found in both women and men. These may include:

Less Common Symptoms

As noted above, the most common types of lung cancer in men tend to grow near the central airways. These tumors tend to cause symptoms earlier on in the course of the disease, with symptoms related to the presence of the tumor near the airway. As such, coughing up blood, obstruction leading to lung collapse (atelectasis), and coughing might be seen earlier in lung cancers found in men than they would be in women.

Another group of symptoms that are seen occasionally with lung cancer is something called paraneoplastic syndrome. Paraneoplastic syndrome is a group of symptoms caused by hormone-like substances secreted by tumors and is seen most often with small cell lung cancers, squamous cell lung cancers and large cell carcinomas—cancers that are found more often in men.

Paraneoplastic symptoms may include an elevated calcium level in the blood (hypercalcemia), a low sodium level, weakness in the upper limbs, loss of coordination and muscle cramps among other symptoms.

Sources:

Harichand-Herdt S. Ramalingam S. Gender-associated differences in lung cancer: clinical characteristics and treatment outcomes in women. Seminars in Oncology. 2009. 36(6):572-80.

Olak, J, Colson Y. Gender differences in lung cancer: Have we really come a long way, baby?. Journal of Thoracic and Cardiovascular Surgery. 2004. 128:346-351.

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