Chronic Cough Due to Lung Tumors: Recommendations

Chronic Cough Due to Lung Tumors: RecommendationsImmediate relief of airway occlusion and many of the symptoms it causes can be expected with endobronchial treatment approaches in 73 to 90% of patients. All endobronchial therapeutic techniques have the potential to provide significant relief of cough and dyspnea, but relief of cough is more troublesome because it is rare that any endobronchial treatment method will totally eradicate the tumor. While cough is improved from 51 to 90% in various series that have reported on this symp-tom, many patients will require some other form of treatment such as centrally acting narcotic antitussive agents to control cough. Nearly all reports on endobronchial treatment methods are case series; randomized prospective controlled trials of such treatment methods are lacking. Brachytherapy is the one endobronchial treatment method in which the relief of cough is often specifically mentioned.

Reports of other endobronchial treatment methods (eg, laser, electrocautery, or stents) have referred to the relief of symptoms globally, but they generally do not specifically mention the percentage of patients who have cough that is relieved by these treatment methods.
For patients with stage I and II NSCLC, surgery to remove the NSCLC is the treatment of choice. If cough was caused by a NSCLC that can be surgically removed, the cough will typically cease. Level of evidence, low; benefit, substantial; grade of recommendation, B
For patients with more advanced NSCLC (stages III and IV), external beam radiation and/or chemotherapy should usually be offered. Level of evidence, good; benefit, intermediate; grade of recommendation, A
For patients with dyspnea or hemoptysis due to endobronchial tumors, cough may also be present. Endobronchial methods should be considered for the palliation of these symptoms, but cough alone is seldom a reason to offer such treatment. Level of evidence, fair; benefit, small; grade of recommendation, C

This entry was posted in Respiratory Symptoms and tagged ablative methods, antitussives, brachytherapy, bronchoscopy, chemotherapy, electrocautery, endobronchial treatment, laser, lung cancer, metastatic carcinoma (to lungs), radiation therapy, stents, Surgery.