Is This Lung Cancer?

I’m an 18-year-old male and lately I’ve been having a hard time breathing. It’s not a sharp pain, it’s like a shortness of breath. And it feels like I should be able to breathe in more deeply than I am. When I try to breathe that deep, I get a dull pain on my left side, in both the front and back. I live with two heavy smokers and was wondering if there are any symptoms of lung cancer that I might want to know about. I read some place that you are more likely to contract lung cancer from second-hand smoking. Or is it something I should just ride out?

Your question is an important one. Basically, how does one know when a chest pain represents something serious? What are the signs or clues to look for, and when do you need to see the doctor?

Let’s start with the easiest and most obvious fact, which is that you are 18 years old. What are the chances of a serious health problem at that age? Well, they are pretty small. Cancer, heart disease and any number of other grim diagnoses are exceedingly unlikely simply by virtue of your young age. This fact is important to remember. Sometimes it is hard to find reassurance in statistics such as these, but the age of a patient is one of the most important and fundamental facts required by a doctor to begin to sort out the many possible causes of chest pain. Of course, many of us fear that we will be the one, the exceptional one, the loser, who falls into the rare statistical category of having a disease that is otherwise unheard of at our age. We fear the worst. And part of the job of a doctor is to bring the facts to bear, to provide reassurance, to let you know that the odds of something really serious are extremely low.

Doc’s Advice 300x279 Is This Lung Cancer?

Is This Lung Cancer?

Also important is your overall health status: If you are a diabetic, or if you have a congenital heart problem, if you are HIV positive, or if you have just been in an automobile accident, each of these will increase the likelihood of various diagnoses. Then your lifestyle and habits come to play: Are you a smoker? Do you binge drink or abuse cocaine or IV drugs? Do you come from a household of poverty where malnourishment and filth abound, or have you been traveling to locations where certain diseases are endemic? An affirmative answer to any of these questions will increase the likelihood of pneumonia or TB, a pneumothorax (partially collapsed lung) and others.

Then we get to the nature of the pain itself. There is a big difference between the crushing chest pressure of a heart attack and the symptoms you report. There is also a big difference between your symptoms and the abrupt and unexplained 40-pound weight loss, shortness of breath, cough and blood-tinged sputum of a lung cancer patient. So we work through these kinds of images, these typical presentations for serious illnesses, and try to narrow the list of possibilities.

In your case, the fact that breathing triggers the discomfort suggests something going on in the chest wall (ribs and muscles). Or perhaps it points to friction between the lung and the inner chest wall. The lung actually glides and moves against the chest wall with breathing. Normally, there is no friction or irritation and therefore no sense of discomfort. But if there is an infection or some other process causing inflammation of the lining of the lung — called the pleura — then pain, or pleurisy, can result.

If pressing on the chest with your fingers reproduces the discomfort, this is a strong sign that something in the chest wall, a pulled muscle or sore rib, is to blame. Alternatively, patients with anxiety will sometimes describe a sense of being unable to draw in a deep breath. They are not short of breath per se, and can usually exercise normally. It is more of a sense of air hunger, or a perceived need to breathe deeply. It may be that conscious (and unconscious) deep breaths are causing discomfort in the muscles of the chest.

These are all possible considerations. Hopefully, these suggestions will help you to determine whether or not you need to see a doctor. You are right to worry about the possibility of cancer from second-hand smoke, but the risk is still very small. It also is a risk that accumulates over time, and it’s apt to take years of heavy exposure to significantly increase your risk. Again, at age 18, the chances of cancer are exceedingly remote.

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