Cough

Coughing can be a distressing symptom and can be persistent, dry or productive. Breathlessness can trigger a cough, and visa versa. Persistent coughing can often cause vomiting, exhaustion, chest or abdominal pain, and insomnia.

Causes

Coughing is a normal mechanism that protects the airways and lungs, and is under both voluntary and involuntary control.

Coughing can be caused by inflammation, irritation or excessive secretions. It can be caused by the lung cancer irritating the airways, or secreting fluids, however there are other causes such as chest infection.

Management

• It is important you discuss any cough symptoms with your doctor or nurse, to enable a full assessment of the cough and the effect it has on you. 
• Management will be determined by the nature of the cough, as well as the patients general condition.

Strategies that help a productive cough

• Drink plenty of fluids as this will help to thin the secretions. Water, juices, canned drinks preferably. Caffeine based tea, coffee and cola are less helpful as they make you pass more urine
• Ensure you are in a comfortable sitting position, e.g. relaxed sitting, relaxed standing, forward leaning or lying on your side with you good side uppermost
• A physiotherapist can advise you on certain types of breathing techniques that may be helpful.
• Some patients find benefit using: Steam inhalation, Nebulised Saline, cough mixtures for productive coughs, physiotherapy to the chest, medication to reduce the stickiness of the sputum

Strategies that help a dry cough

• Try to increase your oral intake, preferably with water
• Suck on sweets or lozenges
• Drink warm honey and water
• Try ice cold drinks or suck on ice pops
• Try breathing in steam from Hot water, you could also try some herbal drops in the water.
• Try cough Linctus or a cough suppressant these can be prescribed by your doctor or nurse.
• Morphine is also used to suppress a cough your nurse or doctor can advise on this
• For a night time cough avoid lying on your back

Haemoptysis (Coughing up of Blood)

Haemoptysis is the coughing up of blood originating from the respiratory tract. This is a symptom that can occur in someone who has lung cancer, and can be very distressing to patients and carers.

Causes.

It is important to establish that the blood or blood stained material has come from the chest and not the Nose, upper respiratory tract, or Gastro Intestinal tract. Usually caused by the cancer invading a blood vessel in the lungs, causing it to bleed Coughing of blood can be transient or persistent and rarely causes a major problem.

Management.

• Ensure your doctor is aware and assessed the cause and severity of the bleeding.
• Sometimes a drug can be used to cause the blood to clot quicker such as Tranexamic acid. 
• Radiotherapy or laser therapy to the chest area can be very effective in sealing the bleeding blood vessel 
• Very occasionally patients can have massive bleeding; in this case management should be regarded as an emergency whether or not resuscitation is appropriate. Your doctor will then advise on the care required.