What should you know about pancoast lung cancer?

A Pancoast tumour is a lung tumour in the upper part of the lung, close to structures at the root of the neck and upper chest. As it grows, it can irritate or compress nearby nerves and bones. This may cause persistent pain around one shoulder or the upper back, pain travelling down the arm, tingling, or weakness in the hand. Some people develop a drooping eyelid or a smaller pupil on one side because nerves to the face are involved. Hoarseness may occur when the tumour affects a nerve that controls the voice box; further information is available on [Hoarse Voice](/symptoms/hoarse-voice/).

The tumour is a form of lung cancer, but its position can make the first symptoms different from the cough or breathlessness many people associate with lung disease. A clinician may assess the chest and nervous system, arrange scans, and take a tissue sample when appropriate. Staging checks whether cancer is confined to the chest or has spread elsewhere, including the brain; see [Lung Cancer](/conditions/lung-cancer/) and [Brain Metastases](/conditions/brain-metastases/) for related explanations.

Arrange a medical assessment for ongoing shoulder or upper-back pain, arm weakness or numbness, unexplained voice change, or other symptoms that do not settle. Bring a record of when symptoms began, what makes them worse, smoking or occupational exposure history, previous scans, and all medicines. A specialist team may discuss imaging, biopsy, lung function, and staging before choosing a treatment sequence.

Treatment can combine several approaches. Radiotherapy and chemotherapy may be used before surgery, and surgery may be considered when the tumour can be removed safely. The operation might involve removing part of the lung, such as a [Lung Lobectomy](/treatments/surgical-oncology/lung-lobectomy/). Testing the tumour’s molecular features through [Genomic Tumour Profiling](/treatments/diagnostics-and-staging/genomic-tumour-profiling/) can help identify treatment options.

Seek urgent medical help for sudden or worsening breathlessness, chest pressure, coughing blood, new weakness on one side, confusion, a seizure, or rapidly worsening arm weakness. These symptoms can have several causes, but they need prompt assessment. A new drooping eyelid with unequal pupils, severe pain, or difficulty speaking or swallowing also warrants urgent advice.

Ask where the tumour is located, what the biopsy shows, and which scans are needed for staging. Ask whether the treatment plan aims to remove the tumour, control it, relieve symptoms, or combine these goals; whether [Radiotherapy](/treatments/radiation-oncology/radiotherapy/) or [Chemotherapy](/treatments/systemic-therapy/chemotherapy/) is recommended; and how treatment may affect breathing, movement, voice, and daily activities. Ask how pain, sleep, appetite, and emotional strain will be supported, including the role of [Palliative Care](/treatments/supportive-and-palliative-care/palliative-care/).