Shoulder and back pain cannot be considered as an early symptom of lung cancer, and cancer is usually not considered in most cases of shoulder and back pain. The first thing to consider is the inflammatory lesions in the shoulder joint itself and the soft tissues around the shoulder joint, as well as the bones, and the most common ones are frozen shoulder, or some tendon injuries, muscle strains, etc. If there is some radiating pain in the back of the shoulder, inflammation such as toothache and coronary heart disease should also be considered. If there is some radiating pain in the back of the shoulder, we should also consider inflammatory diseases such as toothache, coronary heart disease, and even some digestive problems, which can also cause this kind of pain in the back of the shoulder. However, if the shoulder and back pain is caused by lung cancer, it is usually not in early stage, because there are two kinds of shoulder and back pain caused by lung cancer, one is this kind of suprasellar sulcus tumor which grows on the tip of the lung, invades the pleura and stimulates the nerves to cause the pain, however, if there is a suprasellar sulcus tumor which invades the pleura, it is certain that the T stage should be at least T3 or above, and it will not be an early stage in the early stage. The other one is pain caused by bone metastasis, such as invasion of scapula, or direct metastasis of ribs or cervical spine, which causes shoulder and back pain, which is the latest stage IV lung cancer. Therefore, shoulder pain is generally not considered to be lung cancer, but if shoulder pain is caused by lung cancer, it is not early stage.