Is Your Cough a Lung Cancer Cough?
Learn to Identify the Warning Signs
Medically reviewed by Doru Paul, MD
A lung cancer cough can be wet or dry. It may come in fits or spasms. In later stages, coughing may bring up blood or blood-tinged mucus. Lung cancer coughs are chronic, lasting two months or longer.
Much of the time, people with lung cancer experience other signs and symptoms, like fatigue, chest pain, and shortness of breath. There may also be risk factors that, if present, make it more likely that a cough may be due to lung cancer.
While lung cancer is certainly not the most common cause of a chronic cough, it is a possibility. And it's important to note that lung cancer can affect smokers and never-smokers alike.
Since lung cancer is most treatable in its early stages, finding it as early as possible is critical. This is why it's important to see your healthcare provider if you have a persistent cough.
Characteristics of a Lung Cancer Cough
A lung cancer cough isn't easy to identify by type. What sets it apart from other coughs is how long it lasts.
Most coughs caused by other conditions will clear up in a few weeks, but lung cancer coughs are chronic. This means they last longer than eight consecutive weeks. Many people with lung cancer say that their cough "just won't go away."
Takeaway
Smokers can develop a chronic cough, known as "smoker's cough." While not all cases of smoker's cough are related to lung cancer, some may be.
Related: Characteristics of a Smoker's Cough
At least half of people diagnosed with lung cancer have a chronic cough at the time of diagnosis.
This type of cough may:
Be dry or productive, the latter meaning you cough up mucus
Occur at any time of day
Interfere with sleep, resulting in daytime tiredness
A lung cancer cough may seem similar to a cough previously experienced due to something else, like allergies. Because of this, some may not initially be all that concerned about it.
A chronic cough can be caused by other conditions, so its presence doesn't necessarily mean you have lung cancer. Still, it is important to make sure you see a healthcare provider if you have a cough that lasts eight weeks or longer.
Explainer
About 90% of all cases of chronic cough are caused by postnasal drip, asthma, and gastroesophageal reflux disease (GERD). Other conditions and situations that increase your risk of developing a chronic cough include, but are not limited to:
Acute bronchitis
Exposure to dust and chemicals
Use of ACE inhibitors, medications for coronary artery disease, heart failure, and other conditions
Coughing up blood (hemoptysis) can be a warning sign of lung cancer. In fact, is the only sign present in 7% to 35% of people at the time of diagnosis. The blood is often present in small amounts, such as what you would find on a blood-tinged tissue. But any amount of bloody sputum should be evaluated carefully by your healthcare provider.
Related: Causes of Coughing up Blood
Other Lung Cancer Symptoms
The presence of additional symptoms may increase the likelihood that a chronic cough is due to lung cancer.
Studies have looked at people with lung cancer in order to determine what symptoms were present in the year prior to their diagnosis. This research found the following to be independently predictive of lung cancer.
Shortness of Breath
Early on, shortness of breath (dyspnea) is very subtle. It is often noted only with activity, such as climbing stairs. The symptom progressively gets worse over time.
Many people with lung cancer say that they first dismissed this symptom as being due to a sedentary lifestyle or simply growing older.
Related: Causes of Shortness of Breath
Chest Pain
Many people mention that they feel lung pain before they are diagnosed with lung cancer. Pain that occurs with a deep breath, also called pleuritic chest pain or pleurisy, is also common among people who are later diagnosed with lung cancer.
The lungs themselves do not have nerves that sense pain, but pain can be caused by several things, such as:
Pressure of a tumor on nerves
Pain in the ribs from cancer that has spread to the bones
Muscle strain (or even rib fractures) from repeated coughing
Related: Causes of Lung Pain and Treatment Options
Hoarseness
Some people experience hoarseness before their lung cancer diagnosis.
This could be due to coughing, but it could also be caused by a tumor pressing on nerves that travel to the vocal cords.
Related: Why Does My Voice Sound Raspy?
Unexplained Weight Loss
Losing weight when you are not trying to may be a symptom of lung cancer. Unintentional weight loss is defined as the loss of 5% of your body weight or more over a six- to 12-month period. That is roughly 7.5 pounds in a 150-pound person.
There are several other serious causes for this. You should always see your healthcare provider if your weight is dropping, even if you don't mind the direction the scale is moving.
Related: Causes of Unexplained Weight Loss
Respiratory Infections
Many people diagnosed with lung cancer say that their symptoms were first dismissed—by themselves or even their healthcare providers—as being due to a respiratory infection alone.
But when lung tumors grow near the airways, they can cause an obstruction that raises the risk of these infections. Repeated infections such as pneumonia and bronchitis are, in fact, common before lung cancer is diagnosed.
At times, someone may be treated for several episodes of bronchitis or pneumonia before a lung cancer diagnosis is finally made.
Spontaneous Smoking Cessation
It’s been found that a significant number of people with lung cancer reduce the number of cigarettes they smoke or spontaneously quit smoking prior to their diagnosis.
The reason behind this is unclear, but it may be related to trying to ease the symptom of coughing or a subconscious fear of developing lung cancer.
What's interesting is that, oftentimes, very few symptoms of withdrawal occur.
It could be that some lung cancers produce chemicals that decrease the addictiveness of nicotine.
Takeaway
If you've never been able to quit smoking before, and it suddenly seems easy, talk to your healthcare provider.
Risk Factors
Some risk factors for lung cancer—smoking and exposure to secondhand smoke, for example—are well known. Others are not.
And for people who have smoked, having other risk factors may be more than additive. An example can help illustrate this:
If you smoke cigarettes and are exposed to asbestos, your risk of lung cancer is not the sum of the elevated risk incurred by each of these factors. It's greater.
The following are some risk factors of lung cancer to be aware of.
Smoking (Present or Past)
Certainly, smoking is a risk factor for developing lung cancer, with roughly 80% of people diagnosed having a history of smoking at some time.
However, 25% of people who are diagnosed with lung cancer today do not smoke; they are either former smokers or have never smoked.
Unfortunately, unlike heart disease which drops precipitously when a person quits smoking, lung cancer risk never returns to normal. Even if you smoked in the distant past, make sure to mention this to your healthcare provider.
Related: What Percentage of Smokers Get Lung Cancer?
Exposure to Radon
Exposure to radon in the home is the second leading cause of lung cancer and the leading cause in non-smokers. It's thought that radon levels are elevated in one in 15 homes in the United States.
Get your home tested for radon, if you haven't already.
Takeaway
According to the CDC over 64,000 women died of lung cancer in the U.S. in 2019. Each year, between 15,000 and 22,000 people die from radon-induced lung cancer. Since women and children generally spend more time in the home than men, they are, theoretically, at greater risk.
Secondhand Smoke
It’s thought that secondhand smoke accounts for around 7,000 cases of lung cancer in the United States each year.
Family History of Lung Cancer
A genetic predisposition to lung cancer can run in families. This is especially true when lung cancer is found in nonsmokers, in young people, and in women.
Having a mother, father, sibling, or child with a history of lung cancer increases your risk for developing the disease.
Related: Is Lung Cancer Genetic?
Radiation to the Chest
Radiation therapy, such as for breast cancer or Hodgkin disease, increases your risk of developing lung cancer.
Job Exposures
Occupational exposure to chemicals and other substances, such as asbestos, diesel fuel, and more, may increase your lung cancer risk.
This type of exposure is considered a factor in about 3% of lung cancers in men.
Diagnosis
Sometimes a chest X-ray will find lung cancer, but it's possible that it won't.
While chest X-rays were done to screen people for lung cancer in the past, it was found that they failed to detect the disease at an early enough stage to save lives.
A 2015 study done in Denmark found that many people had two or more "normal" chest X-rays in the 90-day period preceding their diagnosis of lung cancer.
A computerized tomography (CT) scan is needed if there is any concern.
As an added bonus, CT scans in the study subjects detected other lung diseases that had been missed on a plain chest X-ray.
Takeaway
It can't be overstated that chest X-rays can miss lung cancer. If you have any symptoms or signs of lung cancer, always ask for a chest CT.
Related: What Is CT Lung Cancer Screening?
When to Call Your Healthcare Provider
If you have a persistent cough—even if you have never smoked, do not have any other symptoms, or believe there is a good explanation for your cough—make an appointment to see your healthcare provider.
The increased risk of lung cancer in smokers is generally far better known by most people than the risk in others. Despite this, a 2016 study found that people who smoke are less likely than non-smokers to seek out medical care for the warning signs of lung cancer—including cough.
A chest CT scan, bronchoscopy, or other tests may be recommended by your healthcare provider if there is concern.
If your symptoms persist and you don’t have an explanation, consider getting a second opinion. Many people with lung cancer say there was a long delay in their diagnosis, and some say that their initial healthcare providers didn’t take them seriously.
Lung Cancer Risk Calculator
If you are between ages 50 and 75 and smoke or have a history of smoking, you can use Memorial Sloan Kettering's tool to assess your risk of lung cancer.
Keep in mind that this is not a substitute for a medical evaluation. And as results are solely based on statistics, it may over- or underestimate your personal risk.
Should You Be Screened?
For those who have smoked in the past, lung cancer screening may be an option. It's thought that the lung cancer death rate could be reduced by 20% if screening is performed on everyone who is eligible.
The United States Preventive Services Task Force (USPSTF) recommends screening using a CT scan for people who:
Are age 50 to 80
Have a 20 pack-year history of smoking
Currently smoke or have quit within the last 15 years
Are healthy enough overall to undergo treatment if diagnosed with lung cancer
The USPSTF advises stopping annual screening for people who have been smoke-free for 15 years or more, or who would not be able to tolerate treatment for lung cancer.
The American Cancer Society also recommends annual screening for current or former smokers in the same age group and pack-year history, but it does not place a time limit on when to stop screening.
A Word From Verywell
Any chronic cough should be checked out by a healthcare provider. Aside from lung cancer, this symptom can be a sign of other health issues, such as asthma, chronic obstructive pulmonary disease (COPD), and more.
And if it turns out that you do have lung cancer, remember that each and every person deserves concern, compassion, and excellent medical care regardless of their smoking history.
Related: The Lung Cancer Ribbon
Read the original article on Verywell Health.
