Symptoms of a Pancoast Tumor

The life expectancy for Pancoast tumors is lower than for other types of lung cancer.

Pancoast tumors, also known as superior sulcus tumors, are a type of lung cancer that invades the top of the lung and can affect the chest nerves, causing various symptoms.

Common signs and symptoms of a Pancoast tumor include:

• Pain in the shoulder or upper arm: This is often the first symptom. The pain can be constant and severe, and worsen with arm or neck movement.
• Weakness or numbness in the arm or hand: The tumor can affect the arm and hand nerves, leading to weakness or numbness.
• Difficulty moving the arm or shoulder: Weakness or numbness may make it difficult to move the shoulder or lift the arm.
• Loss of grip strength: Weakness in the hand and arm muscles can affect the ability to grip objects.
• Changes in sensation in the arm or hand: The tumor can affect the nerves that carry sensations, leading to changes in the arm or hand.
• Changes in skin color and temperature: The skin of the arm or hand may become pale, blue, or red due to changes in blood flow. The arm or hand may feel cold to the touch.
• Swelling in the arm: The tumor can cause fluid buildup in the arm, leading to swelling.
• Horner syndrome: This is a group of symptoms that occur when the tumor affects the nerves controlling the eyes and face, including drooping eyelids, small pupils, and decreased sweating on the affected side of the face.
• Chest pain: The tumor can cause chest pain, especially during deep breathing or coughing.
• Shortness of breath: The tumor may cause difficulty breathing due to airway pressure or fluid accumulation in the lungs.
• Hoarseness: The tumor may affect the vocal cord nerves, leading to hoarseness or voice changes.
• Cough: A Pancoast tumor may cause a persistent cough.
• Weight loss: The tumor may cause unintentional weight loss.
• Fatigue: Many people with a Pancoast tumor experience fatigue.

Other conditions can also cause these symptoms, so it’s important to see a doctor if experiencing any of them.

Causes and Risk Factors for Pancoast Tumors

The exact cause of Pancoast tumors is unknown, but several factors may increase the risk of developing this type of lung cancer. Pancoast tumors affect the upper part of the lung and can invade nearby structures such as the ribs, spine, and brachial plexus (a network of shoulder nerves).

These tumors are relatively rare and occur more frequently in men than in women. They are often found in people who smoke tobacco, and the risk increases with the number of cigarettes smoked and the duration of smoking. People with a history of heavy tobacco use are at the highest risk.

There may also be a genetic component to the development of Pancoast tumors, as some families have a higher incidence of this type of cancer.

Risk Factors for Pancoast Tumors

• Smoking: The most significant risk factor for Pancoast tumors and all types of lung cancer. Tobacco smoke chemicals can damage lung cell DNA, leading to cancerous changes.
• Exposure to harmful substances: Certain industries such as mining or construction can expose workers to dust and chemicals that increase the risk of Pancoast tumors.
• Age: The risk of developing a Pancoast tumor increases with age, with most cases diagnosed in people over 50 years old.
• Gender: Men are more likely to develop Pancoast tumors than women.
• Family history: A family history of lung cancer may increase the risk of developing a Pancoast tumor.
• Environmental factors: Certain environmental toxins, such as air pollution, may increase the risk of Pancoast tumors.
• Genetics: Certain genetic mutations may increase the risk of developing Pancoast tumors.

Having one or more of these risk factors does not guarantee developing a Pancoast tumor, but it’s important to be aware of them and take steps to reduce the risk, such as quitting smoking and avoiding harmful substances.

Diagnosing Pancoast Tumors

These tumors can be challenging to diagnose as they often do not cause symptoms until they are advanced.

Several tests can be used to diagnose a Pancoast tumor:

• Physical examination: A doctor may suspect a Pancoast tumor based on specific physical symptoms such as shoulder or arm pain, arm numbness or weakness, or difficulty moving the arm.
• X-ray: A chest X-ray can help visualize the tumor and assess its size and location. However, X-rays may not always detect Pancoast tumors as they are not always visible in this type of image.
• CT scan: A more detailed imaging test that provides a better view of the tumor and surrounding tissues. A CT scan can help confirm the presence of a Pancoast tumor and determine its size and location.
• PET scan: A specialized imaging test that uses a small amount of radioactive substance to create detailed images of the body’s cells. A PET scan can help detect Pancoast tumors as they tend to be more active and absorb more of the radioactive substance than normal cells.
• Biopsy: A procedure in which a small tissue sample is removed and examined under a microscope. A biopsy confirms the diagnosis and determines the type of cancer cells present, guiding treatment decisions.
• Other tests: Additional tests, such as blood tests or brain imaging, may be performed to evaluate cancer extent and determine the best treatment plan.

Pancoast Tumor Classification

Pancoast tumors are classified based on location and type of cancer cells present.

Different types of Pancoast tumors may include:

• Squamous cell carcinoma: The most common type, accounting for about 70 percent of cases. It arises from flat squamous cells that line the body’s surfaces.
• Adenocarcinoma: Arising from glandular cells that produce and secrete mucus or other substances. Adenocarcinomas can occur in various organs, including the lungs, breasts, and colon.
• Small cell carcinoma: A fast-growing cancer that tends to spread quickly to other parts of the body. Found in the lungs and superior sulcus region.
• Large cell carcinoma: A less common type of lung cancer that grows and spreads more slowly than small cell carcinoma. Characterized by large, abnormal cells not resembling normal lung tissue.
• Mixed histology: A Pancoast tumor combining two or more types of cancer cells, such as squamous and adenocarcinoma cells.
• Other types: Rare types include sarcomas, cancerous tumors arising from connective tissue, and lymphomas, cancerous tumors arising from immune cells.

A diagnosis and treatment plan will be developed based on these factors and the overall health of the affected person.

A diagnosis and treatment plan will be developed based on these factors and the overall health of the affected person.