BonnieB.....you have to answer some important questions:
How old are you?
How many packs a day do you smoke?
How many years have you smoked?
Is there any history of lung cancer in your family?
Do you have any other respiratory symptoms? Shortness of breath? Coughing up blood? Chest Pain? Wheezing? etc.
I'm going to be honest with you, if you've been smoking for many years, as you know, lung cancer is one of the risks (if you're young and have been smoking only a few years, the risk is a lot less). I am very uncomfortable hearing about this arm pain that you have. There are certain lung tumours than can grow at the top of your lung (pancoast tumour) which can, in turn, impinge on a nerve plexus that is situated in your armpit (it's called the brachial plexus). The patient will then complain of arm pain, and discomfort.
I know that telling you this is not going to sit well, but with your history of smoking, and the symptoms you describe it would be irresponsible of any doctor to at least investigate this possibility that I mentioned. It is encouraging that a recent x-ray showed no abnormalities, so that's a huge plus on your side, but like I said, you should get it checked out.
If you can, please answer the questions that I've written at the top of this message.
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