For an 39 AA male who has serious Sarcoidosis in lungs& a history of smoking- can this turn into lung cancer?

He has dropped almost 50 pounds in 6 months and has had sleep apnea but this has went away. He is very weak and tired all the time. Problems and pain while sleeping at night. He has been dealing with the lymph nodes and chronic chest pain symptoms. There was a time when he had a severe cough that wouldn't go away. He doesn't like to go to the doctor, so when his doctor said that he needed another chest xray, he didn't go. It's been years since his last chest xray. He smoked for about 15 years, quit for a few years, started again, and now it's been over a year since he last smoked. We believe that he's afraid to hear that he has lung cancer because the Sarcoidosis has spread to his eyes, lungs, and now his bones. His eyes have gotten better, but he looks very sick. At night he breaks out in sweats, and my question is if this sounds like lung cancer or an advancement from Sarcoidosis? Has anyone else known someone's Sarcoidosis to turn into lung cancer?

Sarcoidosis is an inflammatory, autoimmune disease and is not associated with development of lung cancer, although some of the symptoms may resemble lung cancer in it's advanced stages, especially in stage IV sarcoidosis. It can be a systemic disease causing a lot of pulmonary/respiratory difficulties. Having said that, since this man has a history of smoking, it would not be unthinkable for lung cancer to have developed independent of his sarcoidosis. Certainly, appropriate evaluation by a physician and work up is recommended.