Why you shouldn’t ignore persistent cough

A stubborn cough that refuses to go away and becomes progressively worse, is among the most telltale symptoms of lung cancer. It’s not always a severe cough or of a very specific type. Hence an association with the dreaded disease is not often made. It could be deep and rasping or quite mild, sound wet or dry or may just feel like a tickle in your throat.
While coughing is a normal protective reflex of the body to flush out particles, fluid or irritants in your airways, a lingering, unexplained cough should not be ignored. Research reveals, around 65% of individuals with lung cancer have a nagging cough by the time they are diagnosed.
This symptom incidence spirals to 80% or more for those with advanced disease, when the cancer has metastasized to other parts of the body. So, see your doctor if you have an unexplained cough. Lung cancer is a lot easier to treat when detected early.

What precipitates lung cancer cough?

• Tumours can irritate the airways and trigger a person’s cough reflex.
• The disease can also result in collection of fluid between the lungs and chest. This could cause coughing along with breathlessness and chest pain.
• Tumours can constrict the airways, hampering the body’s ability to expel mucus easily. Hence, germs can stay in your lungs and cause frequent infections like bronchitis or pneumonia, which also leads to coughing.

What are the common features of lung cancer cough?

Continuous need to clear throat
Coughing up blood or jelly-like lumps
Feeling a tickle in your throat
Wet or productive cough

A persistent lung cancer cough can also lead to:

• Sleep issues
• Retching
• Dizziness or headache
• Muscle strains
• Diminished bladder control

What are the other early signs of lung cancer?

• Haemoptysis (Coughing up blood)
• Unplanned weight loss
• Appetite loss
• Fatigue on physical activity
• Chronic lung infections like bronchitis or pneumonia
• Chest pain, especially while coughing, taking deep breaths or laughing out loud
• Hoarseness
• Wheezing
• Depression

What are the treatment options for cough in lung cancer?

The treatment plan should be determined by a Multi-Disciplinary Team, based on the underlying cause of the cough. If a tumour is identified as the cause, the approach may include chemotherapy, immunotherapy, radiation, targeted therapy, or surgery - along with addressing other contributing factors. The final course of action will be carefully tailored and recommended by the Multi-Disciplinary Team.

Medications for cough:

Depending on the cause and the doctor’s advice, the following medications may be used to help manage a persistent cough:
• Prescription or over-the-counter cough suppressants
• Medicines helping to clear mucus
• Bronchodilator inhaler
• Nebulizer with lidocaine
• Opioid drugs like morphine or codeine

Surgical Treatment:

Lung Resection

If lung cancer is found early and hasn’t spread, surgery may be an option. Lung resection means removing the part of the lung where the tumour is located. This can help get rid of the cancer and also reduce symptoms like cough or breathlessness.

There are three main ways this surgery can be done:

1. Open Surgery
A larger cut is made in the chest to remove the tumour. This is the traditional method and may be used for bigger or more complicated tumours.

2. VATS (Video-Assisted Thoracoscopic Surgery)
This is a keyhole surgery done through small cuts using a tiny camera and special tools. It usually means less pain and a quicker recovery.

3. Robotic Surgery
Similar to VATS, but with robotic arms controlled by the surgeon for more precision. It’s also done through small cuts and helps in faster healing.
The doctor and the Multi-Disciplinary Team will decide the best method based on your health and the size and location of the tumour.