Everyone coughs now and then. It’s a protective reflex that helps your body get rid of germs or other harmful things in your airways. But not all coughs mean the same thing. Especially ones that linger.
Studies show at least 65% of people with lung cancer have a nagging cough by the time they’re diagnosed. That number jumps to 80% or higher for those with advanced disease. That’s when cancer spreads to other parts of your body.
Cigarette smoking is the leading cause of lung cancer. But anyone can get it. Talk to your doctor sooner rather than later if you have an unexplained cough. Lung cancer is easier to treat when you catch it early.
Why Does Lung Cancer Make You Cough?
Lung cancer doesn’t always cause a cough. But there are several reasons why it might.
For starters, tumors can irritate your airways and trigger your cough reflex.
Lung cancer can also cause fluid to collect between your lungs and chest. That’s called pleural effusion. It may cause coughing along with shortness of breath and chest pain.
Tumors can also narrow your airways. That blocks your body’s ability to easily expel mucus. As a result, germs can stick around in your lungs and make you sick. You may start to get frequent infections like bronchitis or pneumonia, which also cause coughing.
What Are the Symptoms of Lung Cancer Cough?
It’s persistent, which means it lasts more than 8 weeks.
Lung cancer cough often starts off dry (without mucus) and comes in spasms. It may feel like you constantly need to clear your throat. Later on, you may start to cough up blood or rust-colored mucus (sputum). That’s called a wet cough or a productive cough.
People with lung cancer cough tend to feel very tired. And you may not be able to catch your breath.
Along with fatigue and breathlessness, other common symptoms associated with lung cancer cough include:
- Weight loss without trying
- Loss of appetite
- Trouble with physical activity
You may also have:
- Chest pain (especially when you cough, take deep breaths, or laugh)
An ongoing cough may also cause:
- Trouble sleeping
- Throwing up
- Headache or dizziness
- Muscle strains
- Less control of your bladder
If lung cancer spreads to other parts of your body, you may have:
- Pain in your bones or other places
- Swollen lymph nodes
- Nervous system changes, like headache, weakness or numbness, or balance problems
- Yellow skin and eyes
How Do You Treat Lung Cancer Cough?
Your treatment depends on what’s causing your cough.
If it’s from a tumor, you’ll likely cough less when you treat your lung cancer. You may need chemotherapy, immunotherapy, targeted therapy, radiation, or surgery.
Some medications treat lung cancer cough. They include:
- Prescription or over-the-counter cough suppressants
- Drugs that help you clear mucus (if you have a wet cough)
- Bronchodilator inhaler
- Nebulizer with lidocaine
- Opioid medication like morphine or codeine
Inhalers with corticosteroids may be helpful for some people. But you’ll need to talk to your doctor before you use one. Steroids can affect how your immune system responds to certain kinds of cancer treatment.
Your doctor may suggest an incentive spirometer. That’s a machine that expands your lungs. It can help you take bigger, deeper breaths. It’s something you can do at home after you have surgery. Your doctor or nurse will show you how to use it.
In some cases, endobronchial therapies may help. That’s when your doctor uses special tools to clear away tumors from your airways. They can do this more than once. And they may put a small tube in your airway (called a stent) to keep it open.
You’ll also need to treat any other health conditions that may be causing your cough.
What Are Other Causes of Coughing?
Chemotherapy and radiation therapy can trigger a cough. So might inflammation or scarring from lung cancer surgery. But you can have a cough for reasons other than lung cancer or its treatment.
Common causes of chronic cough include:
- Chronic obstructive pulmonary disease (COPD)
- Other lung diseases
- Heart disease and heart failure
- Chronic or eosinophilic bronchitis
- Acid reflux or gastroesophageal reflux disease (GERD)
Other causes of cough include:
- Air pollution
- Allergies to pollen, mold, or dust
- Postnasal drip
- Cold or flu
- Bronchitis, pneumonia, or COVID-19
Some medications may cause chronic cough, like:
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin receptor blockers (ARBs)
Are There Self-Care Tips for Lung Cancer Cough?
If you smoke, quit. And try to keep away from people who are sick. Respiratory viruses can cause infections that’ll worsen your cough.
Talk to your doctor about home remedies that may help. They’ll let you know what’s safe to use during cancer treatment. Here are some things that might be worth a try:
- Over-the-counter cough suppressants
- Throat lozenges
- Warm water or tea with honey or ginger
- Deep breathing or relaxation exercises
When Should You See a Doctor About a Cough?
Less than 2% of chronic coughs are caused by lung cancer. But it’s a good idea to see your doctor if your cough is new and lasts more than a few weeks. What if you have a history of chronic cough? Tell your doctor if there’s a change in your symptoms.
Here are some questions that may help you find the cause of your cough:
- How long have you had it?
- Is it painful?
- Do you feel like you need treatment to control it?
- How many times a day does it happen?
- Do certain things make it better or worse?
- Does it interrupt your conversations?
- Do you have trouble breathing?
Your doctor will likely give you antibiotics if they think you have a lung infection. If you have bronchitis or pneumonia, along with lung cancer, medication may or may not help you feel better for a little while. Follow up if your cough doesn’t go away or if it comes back in a couple of weeks.
A chest X-ray, CT scan, or MRI scan can show the inside of your lungs. It’s OK to ask for these kinds of imaging tests if your doctor doesn’t order them.
Get a second opinion if your doctor can’t get to the bottom of your cough.
While many doctors can diagnose lung cancer, you may need special help from a pulmonologist. Those are doctors trained to treat lung diseases, including lung cancer.
Sara Greenhill, MD, interventional pulmonology, Northwestern Medicine Palos Hospital.
Sarah Goldberg, MD, MPH, thoracic oncologist, Yale Medicine; medical oncologist (thoracic), Yale Cancer Center; associate professor of medicine, Yale School of Medicine.
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