Pancoast Tumor

Mon, 07/20/2020 - 05:49


60 year old female. Occasionally smoked in my younger years. Maybe 2 packs in a year. Developed shoulder and chest wall and radiates to scapula. I do have scoliosis and joint pain.  I am a nurse and the pain was stressing me.  I went to ED and the did a CT SCAN of chest non contrast. No chest xray or shoulder X-ray.Other than a micronodule and a bulla (both unchanged since 2013 ct scan) and thyroid nodules I'm aware of and are benign) nothing abnormal. Symptons match pancoast so I'm wondering if ct without contrast would have shown this if present.   Thank you very much

JanineT GRACE …
Posts: 586
GRACE Community Outreach Team

Hi Wileysmolly,


Welcome to Grace.  I'm sorry you're having so much pain.  I imagine there's already a lot of stress with the added concern for the virus.  I'm sorry I didn't post your thread sooner, it was an accident. 


A CT without contrast would still pick up a pancoast tumor large enough to cause that kind of pain.  It has to grow out of the lung and reach into the chest wall which is where the pain comes from.  Definitely larger than 3mm, the size limit typically attributed to a lung micronodule. 


Usually, pancoast tumors are caused by smoking, a squamous cell carcinoma.  2 packs in a year probably wouldn't cause mutations enough to cause lung cancer.  

It's 100s of times more likely that this is orthopedic in origin than a pancoast tumor.  I don't know why google insist on giving it so much play. 


I hope you get this straightened out and pain is soon gone.

Be Safe,




I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.

Posts: 1
Hi I’m Ness and I’m 50 years old I’m smoking cigarettes since I was in my 20s but on and off . And I smoke a lot when I become a regular employee for 4 years ago maybe 2 pack a day but I only smoke half and throw away but I think I consume 1 or 2 pack per day . Last July I stop smoking ( because I resign my job and felt sick ) . Last November I went part time job for a week but the work was lifting heavy cans / case of beers 9:00 to 5:00 and my back started to ache , my side breast , my shoulder so I thought I got strained muscle I went to orthopedic they took x ray and said I’m fine . So I waited to see if it’s gonna be ok ,but the pain changes the whole month of December I notice my armpit too started to ache , then my shoulder hurt the most more than my back and my breast side . So I went to see a breast specialist I took some test mammogram and ultrasound sound and the result was ok. But I was worried because the pain is still there although it’s the pain that I can take , it’s just I’m wondering it changes place like my bicep will ache , my wrist , my armpit ( no bumps or lumps) my shoulder , my shoulder blades , very slight chest pain ,my shoulder upper back , lower back pain, headaches, I develop dry cough ( but my chest doesn’t hurt when I cough ) I have clogged nose and sometimes runny nose too that come and go ,so I went to see a doctor clinic near me ( December 30,2022) they took blood test I receive it this January 4,2023 the doctor says it ok but my symptoms are like pancoast lung cancer , so he took an x-ray and the results is ok , I went back the next day just to be sure and he said that the x ray is ok . Is this symptoms of pancoast lung cancer ? Please help I’m worried. One thing I notice is I don’t have constant pain in those areas I mention above it comes and go or still but pain that I can manage I mean not really really hurt , but I notice too that when I do activity work like yesterday I bathe my dog and bought waters galllons so it hurt last night it hurts a lot I took painkillers . I can lift my shoulder too , my arms , my dry coughing is not constant too I mean not a whole day coughing .it’s the bicep and all shoulder ( left side ) and too add to those I think my eyelid are changing a bit on the right side ( or I’m just overthinking)?, my problem is on my left side . I read about Horner syndrome , do your eyelid droop on the opposite side or on the same side where the pain is . Please help what are the pan-coast lung symptoms really are for those who had experience or seen it . I’m going to doctor also next week pulmonologist and neurologist to be check because I don’t where to go . I’m sorry for this long message . And sorry for my English as well since English is not my first language. Thank you

JanineT GRACE …
Posts: 586
GRACE Community Outreach Team

Nessam, Hello and welcome to Grace. I'm so sorry you're having these problems. Please no apologies for your English, it's quite good and completely understandable.

One thing about pancoast tumors is their symptoms list sounds a lot like orthopedic symptoms that many people have. As a personal example, my husband had a pancoast tumor and his symptoms sounded exactly like the symptoms I have from nerve irritation starting in my neck, but soon it became clear that his pain was getting much worse than what I experience. The possibility of having some other ailment is many many times greater than having a pancoast tumor. The pain is mostly constant and very bad. Horner's happens on the same side. X-rays can miss the tumor if it's not directed in its path. MRI can miss it too though both MRI and x-ray usually pick it up.  CT will pick it up if it's there. 


It sounds like you and your doctor are covering the bases with the pulmonologist and neurologist.  I hope you get this straightened out with a bit of yoga and physical therapy...that's what I have to do from time to time, though I should really make it a consistent practice, but that's for another forum :).

Let us know how things turn out or if you have other questions. 


I joined GRACE as a caregiver for my husband who had a Pancoast tumor, NSCLC stage III in 2009. He had curative chemo/rads then it was believed he had a recurrence in the spine/oligometastasis that was radiated. He's 10 years out from treatment.

Amy B
Posts: 11
Executive Director of GRACE

Hi Nessam and thank you so much for being such a terrific advocate for getting as much information as possible about what's going on. I wish everyone was so motivated to get answers before anything progresses (hopefully there's nothing going on with you that is cancerous and this is more muscle/nerve issues). I'm very glad that you're taking action and steps to see so many doctors and try to ascertain what is going on. It is definitely easy to overthink when we're concerned about our health, and having scans and tests are the best way to find the true answers. We are hoping for the best with your upcoming doctor visits and are here to help inform you about what we can.

Amy Bickleman, Executive Director of GRACE

Executive Director of GRACE since 2017. Joined GRACE to ensure that all patients and caregivers are empowered to obtain equal access to education about treatment options.