A woman went to ER with shoulder pain. She was diagnosed with lung cancer that had spread and died 25 days later.

Most people with lung cancer don’t have symptoms until the disease is advanced. peepo/Getty Images A woman went to an ER with shoulder pain and was diagnosed with advanced lung cancer. Doctors said it had spread to her spine, ribs, and adrenal gland, but not her shoulder.

The doctors believe one of the tumors in her spine caused her shoulder pain. A woman who went to an Emergency Room with shoulder pain was diagnosed with lung cancer that had spread to other parts of her body, and died 25 days later, according to a report.  The unnamed 76-year-old first experienced pain in her left shoulder, forearm, and elbow several weeks before seeking help at the ER.

 Soon after, she developed a similar pain on her right side, doctors from the ER in Newark, New Jersey, wrote in the report published in the Cureus Journal of Medical Science on September 2. Tests including a CT scan and biopsy of her bone revealed she had a cancer called an adenocarcinoma in the bottom of her left lung, which had spread to her spine, ribs, and adrenal gland. The woman’s cancer hadn’t spread to her shoulder, but the doctors believe that her pain came from one of the cancerous lesions in her spine.

The woman used to smoke, but not enough to meet the criteria for lung cancer screeningIn the US, adenocarcinoma makes up about 40 percent of lung cancer cases. Smoking cigarettes is linked to this type of cancer, but it’s also the most common cause of lung cancer in people who don’t smoke. The average age of diagnosis is 71 years, and it’s rare before the age of 20.

 The woman was an ex-smoker who had smoked the equivalent of a pack a day for five years, which meant she didn’t meet the criteria to be screened for lung cancer, according to the report.  Adults aged between 50 and 80 who have smoked the equivalent of a pack a day for 20 years and currently smoke, or have quit within the past 15 years, are eligible for screening, according to the US Preventive Services Task Force. The doctors wrote that her cancer had advanced because she didn’t have many symptoms, which delayed diagnosis and made it more challenging to control.

 Advanced lung cancer can cause a cough and breathing problems According to the Genetic and Rare Diseases Information Center, most people with lung adenocarcinoma don’t tend to get symptoms at the early stages of the disease. Symptoms as the condition progresses can include: chest pain, a persistent cough, tiredness, coughing up blood, loss of appetite, unexplained weight loss, and difficulty breathing. One study on the lung cancer family that adenocarcinomas belongs to found that the most common symptoms of the disease were a cough and difficulty breathing.

Most people with those symptoms were diagnosed with adenocarcinoma that had spread to other parts of the body, it said. The treatment for lung cancer depends on how far the cancer has spread at diagnosis, and can include chemotherapy, radiotherapy, and surgery. The woman in the case report was hospitalized and treated with steroids and radiotherapy.

She passed away 25 days after arriving at the hospital due to the “drastic progression” of her cancer, the doctors wrote. Read the original article on Insider.