The symptoms of lung cancer may include: • Having a cough most of the time; • A change in a cough you have had for a long time; • Being short of breath; • Coughing up phlegm (sputum) with signs of blood in it; • An ache or pain when breathing or coughing; • Loss of appetite; • Tiredness (fatigue); • Losing weight. Other less common symptoms of lung cancer are usually associated with more advanced lung cancer. They include: • A hoarse voice; • Difficulty swallowing; • Changes in the shape of your fingers and nails called finger clubbing; • Swelling of the face caused by a blockage of a main blood vessel (superior vena cava obstruction); • Swelling in the neck caused by enlarged lymph nodes; • A constant ache or pain in your chest or shoulder that has lasted some time; • Pain or discomfort under your ribs on your right side (from cancer cells in the liver); • Shortness of breath caused by fluid around the lungs (called a pleural effusion). Some types of lung cancer cells produce hormones that get into the bloodstream. Pins and needles or numbness in the fingers or toes: • Muscle weakness; • Drowsiness, weakness, dizziness or confusion; • Breast swelling in men; • Blood clots (thrombosis). These symptoms are uncommon with lung cancer, but they can happen. Lung cancer growing right at the top of the lung is called a pancoast tumor. These tumors can cause very specific symptoms. The most common is severe shoulder pain or pain that travels down the arm. Pancoast tumors can also cause a collection of symptoms called Horner's syndrome. These are: • Drooping or weakness of one eyelid; • A small pupil in that eye; • Loss of sweating on that same side of the face. These symptoms of Horner's syndrome are caused by the tumor pressing on or damaging a nerve that runs up from the neck to that side of the face. Screening means testing people for early stages of a disease before they have any symptoms. It is an important part of health care for some cancers. For screening to be introduced, we need a test that is simple, quick, not too expensive, and not harmful. Current tests such as X-rays can't usually show early stage cancers and they have some risks. The lungs are very sensitive to radiation and frequent X-rays may cause lung damage. X-rays can also find lung changes that look like cancer and need to be checked by further tests, such as a biopsy. The further tests can cause problems for some people.