Is Your Cough a Lung Cancer Cough?

Are you worried that your chronic cough could be caused by lung cancer? Since lung cancer is most treatable in its early stages, finding it as early as possible is extremely important. Unfortunately, there is no way to know for sure if a cough is due to lung cancer based on symptoms alone.

That said, there are some signs, symptoms, and risk factors that, if also 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.

Warning signs of lung cancer
Verywell / Emily Roberts

Characteristics of ​Chronic Cough

At least half of people diagnosed with lung cancer have a chronic cough at the time of diagnosis. A chronic cough is defined as a cough that lasts for at least eight consecutive weeks. Many people say that their cough just won't go away.

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 one previously experienced due to something else, like allergies. Because of this, some may not initially be all that concerned about it.

People at risk of developing a chronic cough include, but are not limited to, those with the following conditions:

About 90% of all cases of chronic cough are caused by postnasal drip, asthma, and GERD.

Smokers can also 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.

Other Symptoms Associated With Lung Cancer

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.

Coughing Up Blood

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.

This is often just a small amount of blood, such as what you would find on a blood-tinged tissue. But any amount of bloody sputum should be evaluated carefully by your doctor.

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.

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

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.

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 doctor if your weight is dropping, even if you don't mind the direction the scale is moving.

Respiratory Infections

Many people diagnosed with lung cancer say that their symptoms were first dismissed—by themselves or even their doctors—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.

If you've never been able to quit smoking before, and it suddenly seems easy, talk to your doctor.

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 doctor.

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.

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.

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.

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.

When to Call Your Doctor

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 doctor.

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 doctor 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 doctors 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 Lung Cancer?

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.

Screening using a CT scan is recommended 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

People who have been smoke-free for 15 years or more or who would not be able to tolerate treatment for lung cancer are not advised to have yearly lung cancer screening.

A Word From Verywell

Any chronic cough should be checked out by a doctor. 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.

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