Mesothelioma Cough
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Both pleural mesothelioma and asbestos-related lung cancer can cause a persistent, nagging cough as a common symptom. The causes of the cough may be related to cancer, its complications, or treatments. Management of coughing includes treatment of the cancer, medications, and lifestyle or home remedies.
What Is a Mesothelioma Cough Like?
A cough is a common symptom of pleural mesothelioma that worsens as cancer progresses.[1] Most mesothelioma patients with a cough experience a dry, persistent cough that goes on most of the time for weeks or months.
Additionally, patients may have a wet, productive cough that brings up phlegm. Coughing up blood is also possible, especially as lung cancer or mesothelioma progresses.
Coughing as an Early Sign of Mesothelioma
A persistent cough with no obvious explanation—a cold or bronchitis—can be an early warning sign of mesothelioma or other illness. Early-stage mesothelioma often causes a persistent cough, shortness of breath, and pain.
Coughing in End-Stage Mesothelioma
Coughing typically persists as a symptom throughout all stages of mesothelioma. It usually gets worse as the cancer progresses. In late-stage mesothelioma, a patient may start coughing up blood and experiencing more pain with coughing.
How Is a Mesothelioma Cough Different from a Lung Cancer Cough?
While most mesothelioma patients experience a dry cough, it can also be productive and wet. Lung cancer patients have many of the same symptoms as those with pleural mesothelioma. A lung cancer cough is persistent, worsens with time, and is often accompanied by blood.
Should I Be Worried About Cancer if I Have a Cough?
The most important things to note about this symptom is if it persists or if there is no reasonable explanation. If you are not sick, and a cough becomes chronic, you should see your doctor. Describe any other symptoms and if you have smoked or been exposed to asbestos.
How Does Cancer Cause a Cough?
Occasional coughing is a normal response to irritants or secretions in the airway. The mechanism of coughing helps to clear the airways to aid in breathing and prevent infection. A persistent cough, however, is triggered by an underlying condition.[2]
Mesothelioma and Its Complications
Pulmonary cancers, including pleural mesothelioma and lung cancer, can cause coughing as a symptom. Often this is indirect, through the complications triggered by the tumors or the repercussions of asbestos fibers in the airways.
The damage caused by asbestos over the years can lead to irritation that triggers a cough. Inflammation and collection of fluid in the pleural tissue may also be the underlying cause of the cough. It is also common with asbestos exposure and mesothelioma for the pleura to thicken. The pressure of the thickened tissue can cause a persistent cough.
Other complications associated with mesothelioma that can cause coughing include:[3]
- Respiratory infections, like pneumonia
- Pleural effusion, the build up of fluid in the pleura
- Pulmonary embolism, a blood clot in the lungs
- Superior vena cava syndrome, a blockage of this major vein by a tumor
Cancer Treatments
Treatments for mesothelioma may cause or worsen the cough. Commonly, radiation therapy to the chest can also cause irritation that leads to a cough. Surgical procedures may also lead to complications, such as ongoing inflammation or acute infections, worsening the cough, or generating a new cough.
Treatments for a Persistent Mesothelioma Cough
A persistent cough can be uncomfortable, painful, and disruptive. It may limit mobility and activity and even cause social anxiety, leading to withdrawal and isolation.
Patients with a mesothelioma cough can benefit from several management and palliative strategies, from treating cancer itself to using medications and lifestyle changes to reduce coughing.
Treating the Cancer
Coughing itself is not a problem, but it is a symptom of the disease. In any case of persistent cough, the most effective strategy is to treat the underlying condition. In the case of mesothelioma, this means adhering to a patient’s treatment plan.
Surgery, chemotherapy, radiation therapy, or any combination of these or other cancer treatments may help. They reduce tumor size and resulting complications, which in turn may reduce coughing.
Palliative Treatments
Palliative treatments aim to improve symptoms. Sometimes that includes treating underlying cancer, procedures to remove fluid around the lung, or other therapies that might consist of medications to suppress the cough. Draining the fluid from around the lungs can also help.
Cough Medicines
Patients with a mesothelioma cough may take cough suppressants to reduce this symptom. Over-the-counter medications may help but are often not adequate for the persistent, worsening cough many patients experience.
Other antitussives, drugs that target cough, are prescription and may be given to mesothelioma patients opioid cough suppressants, typically with codeine, and levodropropizine, a non-opioid antitussive. These come with risks and side effects, which should be balanced against the benefits.[4]
Lifestyle Remedies
For many mesothelioma patients, lifestyle changes and home remedies bring relief to coughing:
- Avoiding any respiratory irritants, like smoke, dust, aerosol sprays, and allergens
- If smoking, quit. Avoid second hand smoke as well.
- Maintaining good hydration
- Sucking on cough drops and hard candies
- Drinking a warm beverage with honey
- Taking a hot shower or steam bath to moisturize the airways
- Using a humidifier in the home to reduce dry air
A cough may not seem serious, but the consequences are significant when it persists day after day for weeks. Coughing interferes with sleep, talking, socializing, and being active. Talk to your medical team if you are unable to control your coughing associated with mesothelioma.
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Anne Courtney has a Doctor of Nursing Practice degree and is an Advanced Oncology Certified Nurse Practitioner. She has years of oncology experience working with patients with malignant mesothelioma, as well as other types of cancer. Dr. Courtney currently works at University of Texas LIVESTRONG Cancer Institutes.