Cough in Patients With Lung Cancer: A Longitudinal Observational Study of Characterization and Clinical Associations

Abstract

Cough is common in patients with lung cancer, and current antitussive treatments are suboptimal. There are little published data describing cough in patients with lung cancer or work assessing clinical associations. The aim of this study is to fill that gap. This was a longitudinal prospective observational single-cohort study over 60days. Patients were assessed through self-reported validated scales and, in a subsample, ambulatory cough monitoring at study entry (day 0), day 30, and day60. At study entry, 177 patients were included and 153 provided data at day 60. The median duration of cough was 52weeks (interquartile range, 8.5-260). Cough was described as severe enough to warrant treatment in 62%of the patients. Depending on the scale used, performance status was associated with both cough severity and cough impact (P< .001) at study entry, whereas higher cough severity at study entry was associated with female sex (P= .02), asthma (P= .035), and reflux disease (P< .001). Cough impact at study entry was additionally associated with experiencing nausea (P= .018). Cancer characteristics (ie, cancer stage, histology) were not associated with cough severity nor cough impact; neither was smoking or COPD. This is the first study to describe characteristics of cough in patients with lung cancer and to identify clinical associations that may be relevant for its treatment. Our data suggest that cough is a frequent and distressing symptom and an unmet clinical need. Its association with gastrointestinal symptoms in this study may improve our understanding of pathophysiology and therapeutic options for cough occurring in patients with lung cancer.