Persistent unwavering chest rattling, coughing up blood, and mysterious weight loss are some of the most well-known signs of lung cancer.
But shoulder and arm pain can also be a subtle sign that you have the disease which kills around 35,000 Britons every year, around four every hour.
This form of the disease is called a Pancoast tumor and occurs when the cancer develops in the upper part of the lung, usually in cells lining the airways.
From here, the growing tumor can begin to pinch the blood vessels and nerves that run in the shoulder and arm, causing a painful sensation in the limbs.
This can also lead to other problems, such as changes in one eye or the inability to sweat on one side of the face.
Shoulder and arm pain could be a subtle sign that you have a rare form of lung cancer, a disease that kills around 35,000 Britons every year, around four every hour
Lunchtime cancer, while not the most common form of the disease, is one of the biggest cancer killers in Britain with a survival rate of just 10 per cent.
Pancoast tumors are an uncommon form of lung cancer. Only one in 20 people affected by the disease will develop it, which equates to around 2,500 Britons a year.
Lung cancer is the third most common cancer in Britain with around 50,000 diagnoses each year, accounting for 13 per cent of all new cancer cases each year.
It is also incredibly deadly. Only one in ten patients diagnosed with the disease are expected to survive more than ten years.
Patients with Pancoast tumors may face an even more difficult time.
Doctors find it difficult to diagnose them because they do not show up as easily on scans in their early, more treatable stages.
In addition, their catalog of unusual symptoms, such as shoulder pain and facial changes, may lead doctors to suspect that a condition other than cancer is the cause.
As with most cancers, treatment for Pancoast tumors varies depending on the precise location and size of the cancer.
Surgery to remove the tumor is often difficult and requires the extraction of multiple ribs and the replacement of major blood vessels with artificial tubes.
Patients may also need to undergo cancer treatments, such as chemotherapy or radiotherapy, as an alternative or precursor to surgery to shrink the tumor.
Although persistent symptoms of a Pancoast tumor should not be ignored, the main signs for 95 percent of cases are respiratory problems or an impact on general health.
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These include a persistent cough that does not go away after three weeks, repeated respiratory infections, coughing up blood, pain while breathing, persistent shortness of breath and fatigue, and unexpected weight loss.
Other more unusual signs of lung cancer include change in the appearance of your fingers, difficulty or pain when swallowing, wheezing, changes in your voice, and swelling of the face or neck.
Anyone with any of these symptoms is urgently asked to see their doctor.
Data from the charity Cancer Research UK shows that one in thirteen British women and one in fourteen men will develop lung cancer in their lifetime.
It is believed that the vast majority of cases of the disease, about four in five, are preventable.
It is estimated that 72 percent of all cases of lung disease in Britain are caused by smoking.
Another eight percent is believed to be caused by long-term exposure to air pollution, such as that caused by vehicle emissions.
The negative impact of smoking on British health was highlighted in Prime Minister Sir Keir Starmer’s controversial proposal to ban open-air smoking in areas such as pub gardens.
However, a number of respected cancer doctors have described the policy as going too far in restricting people’s right to make decisions about their health.