Pancoast Syndrome (with apologies in advance)

Portal Forums Lung/Thoracic Cancer Work-Up/Staging of Lung Cancer Pancoast Syndrome (with apologies in advance)

This topic contains 2 replies, has 3 voices, and was last updated by  onthemark 3 months ago.

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May 10, 2018 at 3:51 am  #1294393    


Firstly, having looked at this forum in the past, I am in awe of the knowledge, courage and empathy of those that use and support it.

So to my respectful request for advice if i may. I am a 46 yr old non-smoker.

For the past 9 months I have been experiencing slow progressive pain in the scapular (right hand) area that has gotten worse, and now moved more into the shoulder area, with weakness, and now numbness down my right arm a symptom.

During this period I have visited various Osteopaths, through to a shoulder specialist, with no specific diagnosis. Shoulder doc, thought it may be a torn muscle, but EMG proved negative. Only comments were that scapular area is ‘puffy’, and i did show positive on a ‘Whipples’ test (in the right arm)

I have also experienced (last 3 months) droopy eyelid, constricted pupil, but in the left hand eye. Every professional has said that you cannot have Pancoast syndrome, if those symptoms are co-lateral (opposite)

MRI scan of spine/brain in November showed nothing significant, and so a CT scan (with contrast of the chest/neck was carried out recently. Results back yesterday state, no issues, but small shadow likely to be post inflamatory in the right lung. No further action.

My concern through all this time is the slow progression of symptoms, and the obvious concern of what it may be. Also that now the comments of ‘small shadow, which is likely post inflamatory’ have not reduced my fears.

I would welcome any comments on the above, and thank you in advance.

May 10, 2018 at 8:18 am  #1294395    
JimC Forum Moderator
JimC Forum Moderator

Hi broadlands,

Welcome to GRACE. I’m sorry to hear of your symptoms, and I hope you can find some answers and relief from your pain. It’s extremely unlikely that this is caused by a pancoast tumor. A CT scan that fails to show a significant-sized tumor essentially rules out that possibility. You would need to have a fairly large tumor, easily seen on a CT, to cause the type of symptoms you describe.The typical problem with lung cancer is that it doesn’t cause symptoms until the cancer has reached an advanced stage, rather than experiencing symptoms before a tumor has grown.

Again, I hope that you can find a resolution to your issues.

Forum moderator

Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
Sep 2010 multiple brain mets, WBR
Oct 2010 large pericardial effusion, tamponade
Jan 2011 progression, start abraxane
Jun 2011-New liver, brain mets, add Tarceva
Oct 2011-Dx Leptomeningeal carcinomatosis; pulsed Tarceva
At rest Nov 4 2011
Since then:

May 10, 2018 at 3:32 pm  #1294396    


I’m sorry you are having pain and know how worrisome the symptoms you describe can be. I hope you find some relief in Jim’s assurance that it is very unlikely at this point to be a lung tumor. I have also had shoulder and arm pain and was worried for awhile that my lung cancer had come back. It is very easy for these thoughts to get the better of a person sometimes. I had several xrays and have started going for regular massage. This has helped immensely and I am no longer in pain. Perhaps you can also find relief with a massage and/or physical therapy.

10/2015 Chest xray found a nodule as part of a physical (no symptoms).
01/2016 Upper left lobe lingula preserving lobectomy stage 2b for 1.9 cm invasive adenocarcinoma with additional 2 mm AIS nodule found in pathology.
03-05/2016 Sixteen weeks of adjuvant cisplatin/vinorelbine.
07/2016 Durvalumab adjuvant clinical trial discontinued after 1st dose knocked out thyroid.
12/2016 Revised to stage 1b (due to VPI) after new guidelines for multifocal lepidic lung cancer.
07/2019 Next scan.

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