Aprobado por la Junta Editorial de Cancer.Net, 02/2021

Coughing is a natural reflex. It clears your airways of irritants and protects your lungs. A cough can be due to a simple cold or allergies. But some coughs carry more serious risks. People with cancer may also develop a cough related to cancer or its treatment.

You may hear your health care provider describe your cough in different ways:

  • Productive. A productive cough brings up mucus. It is also called a wet cough.

  • Dry. A dry cough does not produce mucus.

  • Acute. A cough that starts suddenly and lasts less than 3 weeks. It is also called a short-term cough.

  • Persistent. A cough that lasts more than 8 weeks. It is also called a chronic cough.

Coughs that last a long time can cause serious problems by disrupting sleep. Severe persistent coughs can also cause vomiting, dizziness, headaches, loss of bladder control, and muscle strains. Other risks include rib fractures, especially for people with cancer that has spread to the bone.

Treating a persistent cough is an important part of your cancer care and treatment. This is called palliative care or supportive care. If you are receiving cancer treatment, you should let your health care team know about a cough that develops.

What causes a cough?

A cough can have many causes. Sometimes there may be more than 1 cause for people with cancer. Causes can include:

Certain types of cancer.

Cancer treatment.

  • Some types of chemotherapy, including bleomycin (available as a generic drug) and methotrexate (Rheumatrex, Trexall, Xatmep)

  • Some types of oral targeted therapy drugs, including osimertinib (Tagrisso) and everolimus (available as a generic drug)

  • Immunotherapy drugs, including pembrolizumab (Keytruda), that can cause inflammation of the lungs

  • Radiation therapy to the chest

  • Hormonal therapies, such as fulvestrant (Faslodex) and letrozole (Femara)

Other medication.

  • Nonsteroidal anti-inflammatory drugs (NSAIDS), used to reduce pain and inflammation

  • Angiotensin-converting enzyme (ACE) inhibitors, used to treat high blood pressure and heart disease

  • Midazolam (Versed), used to relax patients before medical procedures

Cancer-related side effects.

Other health conditions.

  • Chronic lung diseases, such as bronchiectasis or interstitial lung disease

  • Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis

  • Heart disease, including heart failure

  • Asthma

  • Acid reflux or gastroesophageal reflux disease (GERD)

Other common factors and illnesses.

  • Cigarette smoking or breathing secondhand smoke

  • Allergens, such as pollen, mold, and dust

  • Postnasal drip

  • Cold

  • Flu

  • Bronchitis, pneumonia, and COVID-19

How is a cough diagnosed and evaluated in people with cancer?

An occasional cough is usually not something to worry about. But you should let your health care provider know if you have a persistent cough or if your existing cough worsens.

It is especially important to tell your health care provider if you:

Cough up blood. If you cough up blood, you should call your health care team right away or go to the emergency room. This can be a sign that a cancer has spread to the lungs and it can be an emergency. There are many reasons why you might cough up blood that are not an emergency, including as a side effect of radiation therapy, but this symptom should be evaluated by your doctor or an emergency care provider as soon as possible.

Cough up colored mucus. Yellow, green, or foul-smelling mucus could be a sign of an infection. Common colds can cause colored mucus, but so can the flu, pneumonia, and bronchitis. These can be serious conditions for people with cancer that need immediate care. Learn more about when to call the doctor during your cancer treatment.

Experience other symptoms with your cough. Tell your doctor about any new or worsening symptoms like shortness of breath, chest pain, fever, heartburn, vomiting, roughness in your voice, trouble swallowing, a sore throat, or swelling in your feet.

To help learn the reason for your cough, your health care provider may ask you some of the following questions:

  • When did your cough start?

  • How long have you had this cough?

  • How often do you cough and how severely?

  • When does the cough occur?

  • Does anything make your cough better or worse?

Based on your answers, your health care provider may suggest one or more of the following tests:

Chest x-ray. This test takes a picture of the inside of your chest. This test cannot find all problems that can cause a cough, but it can help your health care team diagnose problems like pneumonia.

Computed tomography (CT or CAT) scan. This scan takes pictures of the inside of the body using x-rays and then combines these images into a detailed 3-dimensional image.

Lung function tests. These tests can show how well your lungs are working.

Blood tests. A blood test can show if you have an infection.

Heart tests. An electrocardiogram or echocardiogram may be necessary to see if your cough is caused by problems with your heart.

How is a cough treated and managed?

How your cough is treated depends on what is causing it. In general, it may be helpful to start tracking your cough at home, noting when and how often you cough, to help your doctor determine its cause. Learn more about symptom tracking.

Your cough may have a cause that is unrelated to your cancer. If this is the case, your health care provider can provide treatments to help. For example, such treatment may include antacids to treat acid reflux or steroids for asthma.

For a cough caused by a tumor, you may need chemotherapy, radiation therapy, or surgery. Talk with your health care team about which treatment is best for you.

For a cough with reversible causes, your health care provider will treat the cause of your cough. For fluid around the lungs (pleural effusion), you may need a procedure to remove the fluid. For an infection like pneumonia, you may need antibiotics.

In some cases, it is not possible to treat the cause of a cough or treating the cause will not be helpful. In those cases, you can treat the cough with medication.

Medications commonly used to treat or manage a cough include:

  • Mucus-loosening expectorants, such as guaifenesin

  • Cough suppressants, such as benzonatate, codeine, and dextromethorphan

  • Decongestants

  • Antihistamines

Some of these medications are available over-the-counter. Let your health care team know if you want to take any of these medications.

How to avoid making a cough worse

These tips can help you manage your cough:

  • Avoid smoking and breathing in secondhand smoke

  • Take a hot, steamy shower to loosen mucus

  • Stay hydrated, which makes mucus in the throat thinner

  • Mild exercise can help open your airways, but avoid very strenuous exercise

  • Avoid anything that triggers an allergic reaction in you

  • Avoid throat-irritating aerosol sprays, like hairspray, deodorant, fragrances, and cleaning products

You can also use cough drops, have a warm drink with honey, and use a humidifier if the air in your home is dry. Relaxation techniques, such as deep breathing, can also help with a cough.

Questions to ask the health care team

  • Could the cancer I have cause a cough?

  • When should I call you if I develop a cough?

  • How should I track my cough at home?

  • What treatments do you recommend for a persistent cough?

  • Are there things I can do at home to ease my cough?

  • When should I seek emergency medical care for a cough?

Related Resources


When Cancer Is Not Your Only Health Concern

Benefits of Quitting Tobacco Use

Health Risks of Secondhand Smoke

More Information

American Lung Association: Cough