Cough an unmet clinical need in lung cancer
Cough is a common and distressing symptom with an unmet clinical need in lung cancer patients, a study reports. This symptom is associated with gastrointestinal symptoms but not with smoking, cancer stage, location, treatment and chronic obstructive pulmonary disorder (COPD).
Researchers examined 153 patients over 60 days to determine how cough severity (visual analogue scale), frequency and impact (Manchester Cough in Lung Cancer scale) changed over time, as well as to assess for clinical factors associated with cough severity and impact. Evaluations were conducted through patient-reported validated scales and, in a subsample, ambulatory cough monitoring at baseline and days 30 and 60.
Cough had a median duration of 52 weeks, preceding cancer diagnosis by a median of 12.4 weeks although varying considerably between patients. A proportion of participants (36.2 percent) reported that the symptom began after the diagnosis. Overall, the majority (62 percent) described their cough to be severe enough to warrant treatment.
On multivariate linear regression analyses, performance status was related to both cough severity and cough impact (p<0.001) at baseline. Higher cough severity at baseline was associated with female sex (p=0.02), asthma (p=0.035) and reflux disease (p<0.001), whereas cough impact at baseline was associated with nausea (p=0.018).
Cancer characteristics (ie, cancer stage, histology), smoking and COPD showed no association with cough severity or cough impact.
The present data indicate that cough occurs as a severe and bothersome symptom in lung cancer patients. Researchers pointed out that although current antitussive therapies have limited efficacy with a weak evidence base, new potential targets for antitussive therapies, such as P2X3 receptor inhibition, may be relevant to patients with lung cancer. Additionally, specific management of reflux and nausea may potentially alleviate cough in this population.