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Dr. David
Dr. David, Doctor (MD)
Category: Oncology
Satisfied Customers: 49169
Experience:  Board Certified Oncologist
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Dear doctor, I had asked a question last month regarding

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Dear doctor,
I had asked a question last month regarding lung cancer concerns.
I wanted to ask some more follow up questions but my question was completed and feedback given.
My symptoms are:
Suspected unidigital clubbing in right index finger.
I will upload image which shows nail deformity. The hyponychium looks enlarged and the nail angle at nail bed looks to be decreased. I noticed this at Christmas and I feel it has got worse. I have been to two GPs who don't believe it is clubbing.
I also have intermittent cracks in my voice when phlegm clogs my voice box.
I have 4 pin prick marks on my back which have parathesis. No cough or obvious shortness of breath. Excellent lung capacity and no abnormal sounds.
Ex smoker 20 pack years between 16 years old and 36 years old.
From 36 to present smoked socially around 10 per weekend.
Had 2 episodes of coughing blood in 2009 and 2012. I had chest x rays, c hest CT and Bronchoscopy on both occasions which came back normal. NAD
Does this look like clubbing?
Could this be presentation of lung cancer?
Pancras tumour?
Do not want more x rays so would like to know probability of it being a lung cancer before I would consider more imaging tests.
Many thanks
This is Dr. Davidno, that doesn't look like clubbing.we don't use clubbing as a sign of lung need to stop smoking 100% if you are worried about future lung cancer.a chest xray and chest CT would have seen a pancoast tumor. you don't have to worry about thatlet me know if you have questions.
Customer: replied 2 years ago.
Thank you for response.
What about the small focal point of parathesis on back?
Last imaging tests that not more than enough time for a dreaded tumour?!
I also note periodic hoarseness.
your back is not very sensitive to touch often times. you don't have a lot of nerve sensation on your back.a small focal point of parasthesia would not be a sign of cancer.if you have acid reflux, that can cause irritation of your vocal cords and periodic hoarsenessif you have post nasal drip and mucus running down the back of your throat, that can cause periodic hoarseness of your voice.please leave positive rating above the chat box so I can get credit for helping you todaywe only get credit for helping clients after positive feedbackThanks for using
Customer: replied 2 years ago.
It's not lack of sensitivity, it's a burning or tingling sensation in a tiny area. There are 4 tiny pin prick marks very close together in the area that's tingling/burning. Thx
that most likely is due to a pinched nerve in your spinenot due to a lung cancer.
Customer: replied 2 years ago.
I have tried to send a better photo. You can clearly see a raised profile close to cuticle area. I am petrified this is the start of the loss of nail window. When compared to other index finger there is a definite difference that wasn't there before.
There is also a different sensation. Sometimes painful.
What is causing this difference and nail changes?
The change has increased noticeably from late december to now.
we don't use clubbing as a sign of lung cancer.your prior history of smoking and current smoking can cause hypoxia to your fingers and cause these changes in your nailsif you want your nails to be better, you should stop smoking and exercise regularly to get more oxygen to your finger tips.
Customer: replied 2 years ago.
Unfortunately I have read in some medical journals that clubbing can be a very early sign of lung cancer.
I have stopped smoking completely.
I'm sorry for asking again but does it look like clubbing from the most recent photo?
I am a cancer doctor.clubbing is not an early sign of lung is a sign of hypoxic changes wtih lack of oxygen going to your fingertips from your prior smoking.
Customer: replied 2 years ago.
So you do think it looks clubbed?
I've never had nail issues b4. I stopped smoking heavily 7 years ago and from then to now it has been much reduced to social levels. Plus I would have imagined all nails to have been affected. It is just this far.
I'm going out of my mind with worry.
Sorry to be a pain.
Do you think x-ray is indicated if you think this is clubbing?
it sounds like you are letting your anxiety get out of control with worryit sounds like you will continue to worry about your nails no matter what I can get an xray, it will not show lung cancer.smoking at social events is still bad for your lungs and nailsI can't believe you still smoke if you are this worried about lung are probably smoking to help decrease your anxiety .you might need to see a doctor or psychotherapist about your worries about lung cancer and clubbing if your fingersI don't see clubbing of your fingers.but with your bad anxiety, I suspect you will continue to worry.
Customer: replied 2 years ago.
Dr David, I truely appreciate your advice and you are correct I have let anxiety take hold. Again you are correct on querying why I ever smoked when I am so anxious re this disease and right that I often use cigarettes and alcohol to lessen anxiety. I am desperately trying to accept your advice. I have quit. Believe me. I am NOT being disrespectful.
So to clarify, I will try to accept that:
You do not see any clubbing on my finger.
You do not believe I even have clubbing.
You do not believe I have lung cancer.
You believe an x-ray is unnecessary.
you need to see your doctor to get better treatment for your anxiety than smoking and alcohol.have you been on anxiety medications before?
Customer: replied 2 years ago.
First, do you agree with the 4 end statements I made in my last response?
Second yes I have and they worked very well. Unfortunately I am on Eliquis and many other anti anxiety meds are contraindicated.
yes, I agree with all 4 of those statements.please leave positive rating above the chat box so I can get credit for helping you todaywe only get credit for helping clients after positive feedbackyou can always reach me with "a question for Dr. David" in the medicine or oncology categories if you have any other questionshere is my website if you need to reach me again: for using
Dr. David and other Oncology Specialists are ready to help you
Customer: replied 2 years ago.
Dr David, thank you. There isn't much more you can say to me. I will keep reading your responses until they sink in.
Many thanks from Belfast.