Symptoms of Pancoast Tumors

Medically Reviewed by Gabriela Pichardo, MD on May 11, 2022
Written by Paul Frysh
2 min read

Pancoast tumors are a rare type of lung cancer. They grow in the top part of the lungs.

They don’t cause the same symptoms as other types of lung cancer, like a cough that won’t go away, wheezing, shortness of breath, bloody mucus, or pain when you breathe.

Instead, Pancoast tumors have symptoms that are similar to other, less serious conditions, like arthritis or bursitis. That can make them harder for doctors to diagnose early.

Joint and muscle pain, especially in the shoulder and arm, is the most common symptom of Pancoast tumors. It happens as the tumor grows from the lungs into nearby areas like:

  • Nerves that connect the spine to the shoulders, arms, and hands
  • The tissue between the chest wall and the diaphragm
  • The tissue that surrounds the lungs
  • Your ribs

Your muscles in your shoulders and arms may feel weak, too.

Pain can get worse as the tumor grows, pinching nerves and pushing on muscles. You might feel an ache in your upper back, between your shoulder blades, and even in your armpits.

Pancoast tumors can also press on nerves, and that can lead to other symptoms, such as:

  • Flushing or sweating on one side of the face
  • Numbness and tingling in your arms and hands. In serious cases, you might lose feeling there for good.

Pancoast tumors can also cause a condition called Horner syndrome. It happens when the tumors pinch the nerves linked to the eyes and face, often on just one side. You might notice:

  • A weak or drooping upper eyelid
  • A pupil that’s smaller than the other
  • Little or no sweating on that side of your face

It’s hard for doctors to diagnose Pancoast tumors early. The symptoms they cause are more like those for arthritis or other conditions, so they may not think you have lung cancer right away. Doctors often first see a tumor in a chest X-ray after the cancer has spread to other parts of your lungs.

Once your doctor finds a Pancoast tumor, you may get other imaging scans, such as CT, MRI, or PET scans, which can help your doctor know the size of the tumor and whether it has spread to other areas of your body.

Your doctor will take a small piece of the tumor, called a biopsy, to make a final cancer diagnosis.

Treatment depends on the location and size of your tumor, and how far the cancer has spread. Most people will get a mix of surgery, radiation, and chemotherapy.