Coughing and cancer
Coughing is a reflex action that helps to clear the airway and throat of irritants, but it can also be a significant symptom of serious health conditions, including various forms of cancer, particularly lung cancer. Coughing typically occurs in response to irritants affecting the respiratory system, and while it is common for everyone to cough occasionally, a persistent cough lasting more than two weeks warrants medical evaluation. Chronic coughs can be indicative of underlying issues, including lung cancer, especially when accompanied by symptoms like coughing up blood or chest pain.
Lung cancer remains the leading cause of cancer-related deaths, and it is often characterized by a persistent cough that may produce bloody sputum. Diagnostic procedures such as chest X-rays, CT scans, and bronchoscopy are utilized to identify the underlying causes of chronic coughing. Treatment options vary based on the diagnosis, ranging from medications to manage symptoms to more invasive procedures like surgery or chemotherapy for lung tumors. Preventative measures, particularly avoiding smoking and minimizing exposure to other respiratory irritants, are crucial in reducing the risk of lung cancer and its associated symptoms. Understanding the relationship between coughing and cancer can help individuals recognize when to seek medical help.
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Coughing and cancer
ALSO KNOWN AS: Hacking, barking, expectorating, whooping, tussis
RELATED CONDITIONS: Asthma, pneumonia, lung cancer, melanoma, lymphomas, thyroid cancer, sarcomas, leukemia, and cancer metastasis from primary locations such as the breast, kidney, colon, stomach, rectum, prostate, testis, and bones
DEFINITION: Coughing is the sudden and noisy expulsion of air from the chest in response to an airway or respiratory tract irritation. Coughing causes a repetitive contraction of the thorax.
Etiology and the disease process: Coughing is a reflex that naturally clears the airway and throat of irritants or foreign bodies. It is usually triggered by irritants that stimulate the cough receptors of the respiratory system. A cough starts with a deep breath and occurs when the diaphragm and chest muscles press on the lungs, forcing air through the throat.
Coughing clears the airway or lungs of phlegmsputum. Sometimes a dry cough occurs with postnasal drip, asthma, gastroesophageal reflux disease, or in response to medications such as beta-blockers for blood pressure or aspirin. Smoking is a common cause of coughing. Chronic or persistent coughing lasting two to three weeks with no apparent source usually indicates underlying disease. A cough that lasts months may indicate lung cancer or metastatic cancer.
Incidence: Coughing is a natural response to respiratory irritants, so almost everyone coughs sometimes. When seen by a health care provider for a cough, nonsmokers with a normal chest x-ray will receive a benign diagnosis about 93 percent of the time. However, one of the primary signs of lung cancer is persistent or chronic coughing over an extended time, often with bloody sputum. Over 90 percent of lung cancers start in the bronchi or large tubes that branch off the tracheathe airway that allows air to enter the lung.
Some characteristics of smoking can be indications of lung cancers. Besides persistance, other characteristics include:
- dry cough,
- coughing that interferes with sleep,
- coughing up blood,
- associated chest pain, and
- shortness of breath.
In 2024, lung cancer remained the leading cause of cancer death in both women and men. Projections were that lung cancer would cause an estimated 125,070 deaths in 2024. This was a significant reduction from the 160,440 lung cancer deaths that occurred as recently as in 2004. This drop has been attributed to a large number of people who have either quit smoking or who did not begin. In 2024, about 90 percent of lung cancer in men and 84 percent in women occurs in smokers. Coughing is often a symptom.
Symptoms: A healthcare provider should evaluate any persistent cough lasting over two weeks. Coughing up bloody or rust-colored mucus (hemoptysis) from the lungs may indicate metastasis of the primary cancer for a cancer patient. Lung cancer can narrow the bronchial tubes, causing wheezing and coughing.
Screening and diagnosis: Several tests can be used to determine the cause of persistent coughing. A chest X-ray is a noninvasive screening tool that takes a picture of the chest, heart, lungs, ribs, arteries, and diaphragm. A radiologist examines the X-ray to determine if the patient has conditions such as infections from pneumonia or bronchitis, scarred lung tissue, collapsed lung, tuberculosis, lung cancer, or lung tumor. A computed tomography (CT) scan will show smaller tumors or nodules undetected by a screening X-ray.
Another diagnostic tool is the sputum specimen. The patient produces a deep cough and collects the mucus in a cup. Cultures are collected from the sputum and examined for bacteria or blood. A positive culture confirms abnormal results and indicates a disease is present.
A bronchoscopy is a diagnostic procedure using a flexible or rigid tube put down the nose or throat into the lungs. The health care provider can extract tissue samplesbiopsyor fluids and lung cells for further examination. This is usually an outpatient procedure. Lung cancer is diagnosed through this procedure and the accompanying biopsy examination.
Treatment and therapy: Treatment for coughing depends on the underlying cause. Coughing is generally treated with medications such as cough suppressants and expectorants to loosen the mucus so that it can be expelled. Some cough medications are over-the-counter (OTC), while others, such as codeine, require a doctor’s prescription.
Surgery or chemotherapy may be indicated for a lung tumor. In secondary lung cancer, the malignancy has spread (metastasized) from a primary or distal site to the lungs; radiation therapy may alleviate the coughing by reducing the size of the cancer. If the irritation comes from a blocked airway, laser therapy can sometimes burn the tumor out, then a tubestentis inserted to relieve the pressure and hold the airway open.
Prognosis, prevention, and outcomes: The prognosis for coughing depends on the underlying cause. Because research has confirmed that smoking can cause lung cancer, prevention translates into not smoking. If the coughing is benign or nonmalignantnot cancer-relatedcoughing can be prevented by minimizing exposure to the offending cause. The outcome should be positive if the irritant is removed. Avoiding fumes, toxic chemicals, and known allergens can decrease the incidence of coughing and possible lung cancer. If the coughing is related to lung cancer, treatment of the tumor may reduce the respiratory irritation from the cancer.
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