My 78-year old mother has been complaining of neck and shoulder pain that's getting worse. She started having numbness down the arm so we took her to the hospital. Two doctors consulted on the case and decided she just had degenerative arthritis of the neck. After six weeks in physical therapy, she was no better and maybe even worse. Now she's been told she has lung cancer. Why couldn't they find the real problem sooner?

Constant pain in the neck or shoulder can be caused by a variety of diseases and illnesses. Lung cancer is one cause; heart attack, tuberculosis, and kidney disease are other possibilities.

Older adults can have very complicated health concerns. It isn't always clear when pain comes from aging, collapsing bones and when symptoms come from diseases of the organs. Delay in diagnosis is common and doesn't reflect negligence on the part of the doctor or other health care professional.

Sometimes diseases have so few symptoms, it isn't until the condition gets much worse that the cause can even be found.Only a few cancers can be detected by a blood test. X-rays are often negative for any signs of disease except severe arthritis.

A recent study did show that Pancoast tumors (a form of lung cancer that can cause shoulder and neck pain) can be seen on X-rays in some patients. The doctor must know what to look for to see it early. X-rays of the neck and shoulder usually do show the lung fields. While focusing on the joints and spine, the lung changes may not be seen.