Could It Be Lung Cancer? Persistent Cough Symptoms - Pulmonology

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Could it be lung cancer?


Three months ago, I had a fever and cold, and ever since recovering from the cold, I have been coughing non-stop.
It's been almost three months since I got sick, and the medication hasn't helped.
I’ve been increasingly stressed and worried about the possibility of lung cancer.
My throat itches, which triggers coughing.
When I focus on something, I occasionally forget to cough, but when I remember, it starts itching and I cough again.
The cough is not just a couple of coughs; sometimes it resembles a gagging cough (starting with a few light coughs followed by a heavy cough that feels like vomiting).
After each coughing episode, my abdomen hurts, and then I can go a while without coughing.
The frequency of my cough is about every ten minutes (with occasional light coughs).
At night, propping up my pillow helps reduce coughing.
Recently, I’ve experienced occasional deep breaths that feel like I can’t get enough oxygen.
I also sometimes have sharp pains in my arms, inner thighs, and back of my neck (I’m unsure if it’s bone pain or muscle pain), but I’ve had X-rays done twice: once two months ago and again three weeks ago, both showing no abnormalities.
However, I read online that early-stage lung cancer might not show up on X-rays.
The pulmonologist at the hospital said there’s no need for further imaging, as it’s unlikely for lung disease to develop within a month.
He suggested I might have post-infectious bronchitis or allergic rhinitis.
Why can lung cancer be ruled out? What are the symptoms of lung cancer, and how does the cough present? Is it a persistent cough? If it’s not lung cancer, does the pain from coughing indicate late-stage disease, which would have been visible on the X-ray?

A-Cheng, 20~29 year old female. Ask Date: 2018/03/15

Dr. Huang Yiwen reply Pulmonology


Dear Ah-Cheng: I have reviewed your description, and lung cancer should be ruled out.
Based on your age, chest X-ray, and the interpretation by the pulmonologist, early-stage or even late-stage lung cancer may not necessarily present with symptoms.
Common symptoms such as cough, chest pain, hemoptysis, and weight loss are not typical.
Low-dose computed tomography can be used as a screening tool for healthy lungs.
Changhua Hospital cares about you.

Reply Date: 2018/03/15

More Info


When considering the possibility of lung cancer, especially in the context of persistent cough symptoms, it is essential to understand the nuances of respiratory health and the various factors that can contribute to such symptoms. Your concerns about the potential for lung cancer, particularly after experiencing a prolonged cough following a respiratory infection, are valid. However, it's crucial to approach this situation with a clear understanding of the signs, symptoms, and diagnostic processes involved.

Firstly, persistent cough can arise from various causes, including post-infectious bronchitis, allergies, asthma, or even gastroesophageal reflux disease (GERD). In your case, the cough has persisted for three months following a respiratory illness, which suggests that it may be related to post-viral bronchitis or an allergic reaction rather than lung cancer. The fact that you have undergone two chest X-rays within a short time frame without any abnormalities is a positive indicator. While it is true that very early-stage lung cancer can sometimes be missed on imaging, significant changes typically manifest over a longer period.

Lung cancer symptoms can vary widely, but common early signs include a persistent cough that does not go away, changes in the cough (such as becoming more frequent or producing blood), unexplained weight loss, chest pain, and shortness of breath. The cough associated with lung cancer is often described as persistent and may be accompanied by other systemic symptoms. However, the cough you describe, which is characterized by bouts of intense coughing that can lead to abdominal pain, is more suggestive of bronchial irritation or inflammation rather than malignancy.

Moreover, the presence of other symptoms such as a feeling of not being able to take a deep breath and localized pain in the arms or thighs could indicate muscle strain or tension rather than lung pathology. Stress and anxiety can also exacerbate respiratory symptoms, leading to a cycle of worry that can make symptoms feel more pronounced.

Regarding your question about why lung cancer can be ruled out, the medical evaluation you have undergone, including chest X-rays and the assessment by a pulmonologist, is crucial. These evaluations are designed to identify any significant abnormalities in the lungs. If lung cancer were present, it would typically show up as a mass or lesion on imaging studies. The absence of such findings, combined with your symptoms being consistent with bronchitis or allergies, supports the conclusion that lung cancer is unlikely at this time.

If you continue to experience symptoms, it may be beneficial to explore further evaluations, such as a low-dose CT scan, which can provide more detailed imaging of the lungs. Additionally, addressing any underlying issues such as allergies or asthma with appropriate medications can help alleviate your symptoms.

In summary, while it is understandable to be concerned about lung cancer given your symptoms and history, the current medical evaluations suggest that your symptoms are more likely related to bronchial irritation or post-viral effects rather than malignancy. It is essential to maintain open communication with your healthcare provider, follow their recommendations, and consider further evaluations if symptoms persist or worsen. Regular follow-ups and monitoring can help ensure that any changes in your health are promptly addressed.

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