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Cough may be present and sometimes troublesome. It can occur due to irritation by the tumour, pleural effusion, phlegm, chest infection, pre-existing chest disease or heart problems.

Infection and heart problems need to be excluded or treated first by a doctor. Assessment may require a chest x-ray or CT scan. Medications for pre-existing asthma or other chest conditions should be continued.

If a dry cough is troublesome it may be suppressed by codeine, pholcodine linctus, or oral morphine solution. Sometimes it can be relieved by saline (salt water) via a nebuliser. Thick phlegm may be relieved by carbocisteine (Mucodyne capsules or liquid) which liquefies secretions. Excessive moist secretions may be relieved with medications such as hyoscine (can be obtained in a patch that lasts for 3 days) or glycopyrrhonium although this has to be given by injection. Occasionally cough may require treatment with steroids or drugs usually used for other conditions such as baclofen (antispasmodic), nifedipine (often used for cardiac conditions) or paroxetine (antidepressant).

Self-help measures include positioning may help. Propping up on pillows makes coughing more effective at expelling phlegm, inhalation of steam and encouraging adequate hydration, particularly with hot drinks.  Click here to download a booklet providing further information on coughing.