Introduction Cough in lung cancer (LC) is a distressing symptom with a significant impact on quality of life (QoL), and no effective therapies. Little data is available defining the proportion of LC patients affected by cough or its impact. This study determines the prevalence and characteristics of cough in LC using validated assessment tools, including the new LC-specific impact scale: Manchester Cough in Lung Cancer Scale (MCLCS).
Patients and methods Consecutive patients attending a single-centre LC outpatient oncology clinic were enrolled over a 5-week period. Every patient was asked “do you have a cough?” Patients who answered yes had their cough assessed using a cough severity Visual Analogue Scale (VAS) and the MCLCS. Clinical and demographic data were collected.
Result A total of 224 patients were enrolled; 55% male; 10% never smoked; 31% small cell lung cancer (SCLC) and 52% had a performance status (PS) of 2 3. The cough prevalence was 58%; 53% felt their cough warranted treatment and 23% reported painful cough. Mean MCLCS 22.7 (8.1 ± SD, range 0 50: 50 = worst cough QoL) and VAS scores were 36mm (21.3 ± SD). Painful coughs scored higher on the VAS and MCLCS (mean VAS 45.7mm vs.33.3, p = 0.034, mean MCLCS 28.0 vs. 19.6 p>0.005). Coughs warranting treatment also scored higher on the VAS and MCLCS (mean VAS 47.2 vs. 23.8 p>0.005, mean MCLCS 25.4 vs. 17.1, p>0.005 respectively). Cough prevalence was higher in patients off anti-cancer therapy (63% vs. 50%, p = 0.048). Cough had a greater impact on mean MCLCS scores in poor PS patients (p >0.0005).
Conclusion This is the first study to assess the prevalence of cough in a large clinical cohort of outpatients with LC and to characterise cough using validated assessment tools. Cough was most severe coughs and had greatest impact on quality of life in patients who described their cough as painful or warranting treatment. The MCLCS and VAS are simple cough assessment tools that can be readily used in research and clinical practice to better evaluate cough and facilitate the development of effective cough therapies.