A persistent unshakable chesty rattle, coughing up blood and mysteriously losing weight are some of the most well-known signs of lung cancer.
But shoulder and arm pain can also be a subtle sign you have the disease that kills some 35,000 Brits each year, about four every hour.
This form of the disease is called a pancoast tumour, which happens when the cancer develops in the top part of the lung, most commonly in cells lining the airway.
From here the growing tumour can start to pinch blood vessels and nerves that run into the shoulder and arm causing a painful sensation in the limb.
This can also result in other problems like changes to an eye or an inability to sweat on one side of the face.
Shoulder and arm pain could be a subtle sign you have a rare form of lung cancer a disease that kills some 35,000 Brits each year, about four every hour
Lunch cancer, while not the most common form of the disease, is one of the biggest cancer killers in the Uk with a survival rate of just 10 per cent
Pancoast tumours are an uncommon form of lung cancer. Only one in 20 people hit by the disease will develop them, equivalent to about 2,500 Brits each year.
Lung cancer is the third most common cancer in the UK with about 50,000 diagnoses per year, accounting for 13 per cent of all new cancer cases per year.
It is also incredibly deadly. Only one in 10 patients diagnosed with the disease are expected to survive for over a decade.
Patients with pancoast tumours can face an even more difficult time.
Medics find them difficult to diagnose as in their early, more treatable, stages they don’t show up as easily on scans.
Additionally, their catalogue of unusual symptoms like shoulder pain and changes to the face can make doctors suspect another condition, rather than cancer, is the cause.
Like most forms of cancer, treatment for pancoast tumours varies depending on precise location and size of the cancer.
Surgery to remove the tumour is often difficult, requiring the extraction of multiple ribs and the replacement of key blood vessels with artificial tubes.
Patients may also need to undergo cancer treatments like chemotherapy or radiotherapy as an alternative or precursor to surgery to reduce the size of the tumour.
While persistent symptoms of a pancoast tumour shouldn’t be ignored the main signs for 95 per cent of cases are respiratory or an impact on general health.
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These include a persistent cough that doesn’t go away after three weeks, repeated chest infections, coughing up blood, pain while breathing, persistent breathlessness and fatigue, and unexpected weight loss.
Other, more unusual signs of lung cancer include change in the appearance of your fingers, difficulty or pain swallowing, wheezing, changes in your voice, and swelling of the face or neck.
Anyone with any of these signs is urged to see their GP.
Data from charity Cancer Research UK suggests one in 13 British women and one in 14 men will get lung cancer in their lifetime.
The vast majority of cases of the disease, about four in five, are thought to be preventable.
An estimated 72 per cent of all cases of lung disease in the UK are thought to be caused by smoking.
Another eight per cent is thought to be triggered by long-term exposure to air pollution, such as that caused by vehicle emissions.
Smoking’s toll on Britain’s health was cited by Prime Minister Sir Keir Starmer’s controversial proposal to ban outdoor smoking in places like pub gardens.
However, a number of respected cancer doctors have described the policy as going a too far on limiting people’s right to make decisions about their health.
