Oncology (General Cancer)/Chest Pain/Lung Cancer

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Question
Hi Doctor,

I am a 52 year old male non smoking in otherwise good health ,no daily medications. For the past three weeks I have had fairly persistent right side chest pain radiating at times to armpit and back. Do not feel it is cardiac related, I jog 6 to 7 miles a day with no additional problem. No cough, shortness of breathe, or blood in sputum, with a slight unexplained weight gain about 6 pounds. Some pain at times when swallowing solids at mid chest near right bronchi with no difficulty getting food down. My Gallbladder was remove about 15 years ago. I have had bouts of costochondritis in the past on this side that had lasted a couple months then passed, but that pain seemed more centralized then what I am experiencing although similar. My concern is  this pain is possible lung cancer. My father died of lung cancer at 59, he was a smoker, and my brother, non smoker died of colon cancer at 52, both diagnosed in their 50s.My fear is that I am going to suffer the same fate.  Because of this fact, I have always been a bit paranoid and, have always insisted on getting every ache, and pain thoroughly checked out, as a result of this and some other past medical issues I have been exposed to more diagnostic radiation then I would prefer, with thank God most times nothing serious resulting. Do you feel this sounds like lung cancer? In your opinion, should I see a GP or, go directly to a  pulmonologist? I hear many nightmares of how GPs misdiagnosis Lung cancer and rely on just a chest X-rays that are not the best at spotting all lung tumors. Putting it off as muscular pain, or acid reflux delaying diagnosis for months. This is what happened to my father diagnosed 8 Months after pain began to late at that point stage 4 adenocarcinoma left lung. Please advise.

Thank you for your time
Kevin

Answer
If you've never been a smoker, and you are otherwise in good health, it doesn't sound like lung cancer.  If there are no pulmonary symptoms at all, and the symptom has only been going on for three weeks, I would feel strongly that it is due to something else.  Usually lung cancer does not present with pain, the exception being tumors that arise at the top of the lung and can cause pressure to the nerves going into the arm.  
That being said, it may be nothing more than chondritis, although the radiation is more like some arthritis in the shoulder. That can definitely give you intermittent radiating pain as you describe.  Other much less likely possibilities include mesothelioma, injury to the back of the heart (really rare) and some process in your right abdomen.  Since you've had gall bladder disease, you might have irritation of the bile duct or something else going on in the liver area.  
I don't think your swallowing issue is related to your chest discomfort.  
As always, if symptoms of either get worse, you need to be checked out.  I might suggest a brief trial of ibuprofen (400 mg taken three times a day) or acetamenophen, 500 mg three times a day.  if the chest pain goes away it was probably "musculoskeletal" and not serious.  
Chest xrays are not perfect, but most of the time if there is something going on in the lung, you can tell.  Any abnormality should be followed up with a CT scan.  And a good GP should be able to get you into the hands of the right specialist, if necessary; I don't think a pulmonologist would be of much help here.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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