Pancoast Tumor symptoms ?

Sat, 03/21/2020 - 09:59

Hello everyone,

I'm a 21 yo nonsmoker and since january I've been experiencing pain on the upper right side of my body. It all started with chest pain that would get worse while breathing deeply, stopped suddenly for a couple weeks and then came back, except it was now affecting my shoulder aswell. I am now experiencing upper right chest pain, cervical stiffness and shoulder pain that shoots all the way down to my fingers - the shoulder pain is dull, numbing and not made worse by any movement,  in fact lifting my arm shakes the pain away for a few seconds. Additionally, I've recently notice the presence of a small and very hard bony lump at the joint between my right palm and middle finger, slightly sore to touch. All pains usually gets better at rest.

I went to my GP a few weeks ago who told me it was nothing serious, but since I started experiencing finger and hand pain (as well as that lump) it got me excessively worried again. As many people do I went on to check my symptoms on google, and the only thing that somewhat matches is pancoast tumor (typically shoulder pain shooting to fingers). I know very well that lung cancers in the early 20s are extremely rare, but still it makes me nervous and interfers with my daily life. Additionally, given the current medical situation in my region (Western Europe) I am unsure if I will be able to get further examinated by a specialist and get a chest xray anytime soon. What do you think ? I imagine that actual pain related to pancoast tumor would be unrelenting even at night and I guess i wouldn't be so anxious if i didn't have this shooting pain in hand. Also I have no idea where that lump could come from.


Thanks for taking the time to read me.

JanineT Forum …


I'm very sorry you're going through this.  It doesn't particularly sound like typical pancoast tumor pain.  That pain is normally in the back around the scapula not in the chest.  It causes arm pain to an extent where you have to hold your elbow and is unrelenting. 


It's not unusual for orthopedic problems in the area to cause pain to run down the arm to the hand.  There's a bundle of nerves that can cause lots of problems for lots of people.  As I write this my hands are becoming numb that come from around the scapula and down the arm.  It comes from a disc issue.  This type of pain is wildly more likely not cancer related even if you were a 60 year old long time smoker.  The finger thing doesn't sound like a symptom of pancoast either. 


With that said we can't tell you what's bothering you or if it's cancer or not.  You're right a doctor is likely to tell you you'd be better off staying at home because of the virus.  I know in the U.S. I could get an online appointment with my primary doc.  If the pain continues to worsen make sure you keep your doc updated. 


I wish I could be of more help and I hope you feel better.    



Hey Janine, sorry that I didn't reply earlier. I wanted to update this post, because its now September and I am still in a fair amount of pain.

My symptoms didn't improve despite following physiotherapy and seeing several chiropractors and osteopaths, and I'm experiencing constant pain in my right shoulder joint, which is only temporarily relieved by cracking my shoudler or lifting my arm up, and some pain in my ribs - especially at the junction between my first rib and clavicle (in addition to everything i previously mentionned - the arm and hand pain I experience mostly occur following the ulnar nerve path).During days of high pain i'd describe it as a constant 5/10 ache, sometimes dull sometimes throbbing. No "classic" painkiller has a real effect on my pains, only benzodiazepines, sleeping or taking a hot bath give me some relief. All specialists said that my upper back and shoulder muscles were abnormaly tense and after a session of massage/adjustments they claim that they relieved most the tension and that I should be in less pain, but its never actually the case - it just comes back after a few hours. Obviously I was reffered to an xray (which came back clear beside the presence of whats believed to be an "azygos lobe" on my right lung) and then a cervical/thoracic spine MRI (which picked up nothing either accorrding to the radiologists - not even an herniated disc). The issue is despite scans coming back clear, the pain doesnt feel like it's gonna stop anytime soon - quite the opposite actually. I've seen 3 GPs and none of them can really pinpoint the cause of my pains, and it's really worrying me. I believe given the amount of pain I'm in, if it was a tumor causing it it would be large enough to be seen on an MRI ?  It's really getting difficult to deal with for a 21 yo like me and idk what to do, everyone my age lives a normal life but I can't because the pain is constant and often cant be ignored, I went out for holidays with my parents on august and missed out on most things cuz I was just in so much pain and anxiety. Maybe seeing a psychologist could be of some help because my morale is really going downhill, the pain dictates my life atm (day of low pain - decent mood, day of high pain like today - feeling very low, don't feel like even getting out of my room). 

JanineT Forum …

Hi Mello7,


I'm really sorry you're having no luck with finding a cause for the pain.  An xray and MRI are not likely to miss a pancoast tumor but they can, however a chest CT wouldn't miss it.  It's even more unlikely, mostly unheard of that someone your age would have such a tumor.  The truth about pain like you discribe is that there's often not a diagnosis.  There 's so much going on in the area around your shoulder that nerve irritation is pretty normal.  Don't give up on finding a cause.  Personally, I've had such problems for as long as I can remember and the best 2 things I've found to help are bikram yoga (carefully appointed posture alignment and strengthening) and basic PT exercises for specific pain.  Don't give up hope of or diligence in finding to culprit so you can mitigate and hopefully get rid of it for good.


Let us know when you figure it out, hopefully sooner than later


In reply to by JanineT Forum …


Hey, thanks for replying !

I know it's extremely unlikely for someone my age to grow a lung tumor, especially since it went unnoticed on both the xray and the MRI, but even knowing that the pain is still very present and sometimes debilitating. I've tried to ask my regular GP for a CT scan but was denied it since I already had an MRI - to him I'm just worrying over nothing and it's probably the case; yet not finding a real cause for this type of chronic pains (which to me, kinda sounds like the type of pain pancoast tumor could produce according to what I read) makes me quite anxious. I was even denied a simple shoulder xray as I'm getting a lot of joint pain and loud cracks. I guess if I really want more imaging done the safest bet would be to go directly to the hospital..

As of now I'm still following physiotherapy (mostly consisting of stretching and massaging the tense muscles) which is helping a lot with short term management of pain, but so far no long term solution can be found. It's a bit scary but I'll just keep on working on finding the cause of it all while trying to live a normal life. 

Take care !