Day 18 - “SYNDROMES” ASSOCIATED WITH LUNG CANCER

Day 18 – “SYNDROMES” ASSOCIATED WITH LUNG CANCER

In addition to causing symptoms, some lung cancers can cause “syndromes”, or groups of very specific symptoms. Among these are Horner Syndrome, Superior Vena Cava Syndrome, and Paraneoplastic Syndromes. Let’s take a closer look at each type.

Horner Syndrome: Affecting the nerves of the eye and face on the same side of the body, some cancers located toward the top part of the lung can sometimes cause drooping of an eyelid, a smaller pupil, reduced sweating, or even shoulder pain.

Superior Vena Cava Syndrome: The SVC (Superior Vena Cava) circulates blood from distant places in the body, such as the head and arms, back to your heart. Tumors can push on this vein and cause blood to pool in areas of the veins, leading to a variety of symptoms. Edema (swelling due to an overabundance of fluids collecting in the area) of the arms, neck or face, shortness of breath, swallowing difficulties and wheezing are common symptoms of this syndrome.

Paraneoplastic Syndromes: As if the signs and symptoms of most lung cancers weren’t already common enough to frequently be attributed to other illnesses, here come the paraneoplastic syndromes to potentially confuse diagnosis even more.

Some lung cancers secrete substances that travel to distant tissues and organs and act like hormones, even though there is not cancer located in that area. It is theorized that the body’s own immune system is attacking its own cells, trying to create antibodies to attack existing cancerous cells in the body. The syndrome is the sign of the underlying disease. There are several types of paraneoplastic syndromes:

- SIADH (Syndrome of Inappropriate Anti-diuretic Hormone) might be identified when the salt level in the body is lowered because the kidneys are retaining water. Fatigue, cramps or weakness of muscles, loss of appetite, restlessness, nausea and vomiting, and confusion may occur.

Hypercalcemia (high levels of calcium in the blood) may cause excessive thirst, constipation, abdominal pain, frequent urination, dizziness, and other nervous system problems.

Cushing Syndrome can be characterized by symptoms such as weight gain (particularly in the face (‘moon face’) and at the base and back of the neck (‘buffalo hump’)), muscle weakness, fluid retention, high blood pressure, and sometimes even diabetes and high blood sugar.

Nervous System Problems are rare and important disorders which can cause a variety of symptoms if the body’s own immune system attacks the nervous system: Loss of balance and possible difficulty swallowing or speaking (paraneoplastic cerebellar degeneration), hip muscle weakness (Lambert-Eaton syndrome), and blood clotting concerns (Trousseau’s Sign, or Syndrome) are all examples. Various organ functions including neurologic, dermatologic (skin), endocrine (hormone), rheumatologic (joints), hematologic (blood), and ophthalmologic (eye) symptoms/syndromes may be impaired.

Blood clots, painful thickening of certain bones (such as fingertips), and excess breast growth in men (gynecomastia) can also occur.

Sometimes identifying these symptoms is the first thing to alert the patient and doctor that there is underlying lung cancer; sometimes symptoms mimic those of metastasis (spread of the cancer to other organs or tissues), or even resemble side effects from treatment (namely neuropathy (tingling in limbs) and changes to the nervous system, such as balance and coordination, or muscle use). Diagnosing and treating the syndrome itself may affect overall clinical outcomes for the better.

RESOURCES: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931619/, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127595/,

https://www.brighamandwomens.org/neurology/critical-care-neurology/paraneoplastic-syndrome,

http://www.bloodjournal.org/content/110/6/1723?sso-checked=true,

https://www.cancer.org/cancer/lung-cancer/prevention-and-early-detection/signs-and-symptoms.html,

https://en.wikipedia.org/wiki/Superior_vena_cava_syndrome, and

https://en.wikipedia.org/wiki/Horner%27s_syndrome