It should be noted that, for some patients, hemoptysis is the first sign of a disease that forces you to see a doctor, this symptom cannot be considered an early manifestation of lung cancer. Shortness of breath — increased breathing against the background of steadily increasing respiratory discomfort, the appearance of a feeling of lack of full breath or lack of air — is characteristic of advanced stages of the disease. Its occurrence is most often associated with tumor stenosis of one of the large bronchi, especially the main one, with the accumulation of exudate in the pleural cavity, atelectasis of significant sections of the pulmonary parenchyma. Along with the reflex mechanism of this symptom. contraction of the canal of the pulmonary circulation in the affected lung, “bypassing” part of the blood is of certain importance in its formation. The onset and progression of dyspnea can be caused by the displacement and compression of a large tumor or its metastases of the anatomical structures of the mediastinum, especially veins and trachea. At rest, shortness of breath is often absent, but always appears during physical exertion, movement, especially when climbing stairs. The timing of the occurrence of shortness of breath and its limitations, varying degrees of severity allow us to judge the degree of respiratory failure in patients with lung cancer and, in part, the prevalence of blastomatous lesions.

Chest pain is a common symptom of a lung tumor. Usually they occur on the side of the lesion, are of varying intensity, alternating or constant. The appearance of pain, often perceived as “neuralgic”, emanating from the wall of the chest cavity, is usually caused by the progressive involvement of the parietal pleura, intrathoracic fascia, ribs in the tumor process. such pain intensifies with deep breathing, movement. Another group of pains, regarded as deep, intrathoracic, not clearly localized, is associated with the spread of central lung cancer to the main bronchus, the area of ​​tracheal bifurcation. These pains are not associated with movement, breathing.

At first, the pain is short-lived, transient in nature and almost does not bother. As the tumor develops, they become permanent, depriving patients of rest and rest, especially at night. The location of the peripheral tumor in the upper lobe of the lung with a transition to the pleura and above – the distribution area of ​​the branches of the VII cervical and I – II pectoral roots of the spinal nerves, as well as on the trunk of the sympathetic nerve passing here, causes especially intense pain, often combined with a group of other symptoms, described in 1924 by N.K. Pancost. They are characterized by: pain in the shoulder girdle on the side of the tumor affected by the tumor, impaired skin sensitivity and atrophy of the muscles of the upper extremity, destruction of the transverse processes and vertebral bodies, the appearance of Bernard-Horner syndrome (ptosis, myosis, enophthalmos, impaired lacrimation from the eye on the side of the tumor in the lung). Such lung cancers from this time received a special name – “Pencost type”.

An increase in body temperature in patients with lung cancer, as the disease develops, undergoes a characteristic dynamics. At first the most common and how

as a rule, episodes of an increase in body temperature to subfebrile digits, which do not always find an explanation , are little disturbing . In this period, even without any treatment, the temperature drops to normal levels for a short time. The cause of the temperature reaction in this early period of lung cancer development is usually secondary, even small changes in the affected part of the lung in the form of impaired ventilation, impaired motor-evacuation function, and self-cleaning processes. As the tumor grows and develops, inflammatory changes progress as well. They involve the atelectasis of the lung, parietal pleura, airways. Then the temperature reaction also changes: it becomes longer, the breaks between its episodes are reduced. At this time, the use of antipyretic and anti-inflammatory drugs at home, which most patients resort to, can reduce or even eliminate the temperature reaction for a short period. Relapses become very characteristic then – the return of episodes of an increase in body temperature, as well as its resistance to previously used successfully drugs. Finally, the temperature increase becomes continuous or constant, with slight fluctuations in the morning and evening hours of the day. This type of temperature reaction, caused by the development of a malignant tumor in the lung, is sometimes called “cancer fever”.

Damage to a lung tumor of nearby anatomical formations of the chest cavity is manifested by peculiar clinical symptoms. Often they are so pronounced and disturb the patients so much that they are the main of the complaints. The transition of the tumor to the intrathoracic fascia and ribs is accompanied by the onset and progressive growth of dull and sharp pains. As a rule, their localization quite accurately corresponds to the location of the tumor in the lung. At first, the pains are of little concern, they are eliminated by taking painkillers or thermal procedures and rubbing, which some patients resort to. Moreover, most often they explain these phenomena as “the development of myositis after physical work” or “intercostal neuralgia due to cooling”. Some patients regarding these health disorders seek the help of a neuropathologist.