{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T08:46:54Z","timestamp":1782982014566,"version":"3.54.5"},"reference-count":49,"publisher":"The Korean Academy of Tuberculosis and Respiratory Diseases","issue":"3","license":[{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-trd.org"],"crossmark-restriction":true},"short-container-title":["Tuberc Respir Dis"],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:p>Cough is a prevalent symptom in lung cancer that impairs quality of life. Postoperative cough after pulmonary resection (CAP) has an incidence of approximately 21.1%\u201355.8%. CAP tends to peak around 1-month post-surgery, and often improves by 3 months. Risk factors for persistent CAP include female sex, extensive resection (e.g., lobectomy or lymph node dissection), and postoperative gastroesophageal reflux. Pulmonary rehabilitation programs significantly reduce postoperative cough incidence and improve cough-specific quality of life. In patients with lung cancer, cough occurs in over 50% of cases, regardless of stage or histology. A stepwise management algorithm is recommended: first treat the cancer and any contributing comorbidities, then use simple demulcents to soothe airways. If needed, add centrally acting antitussives such as codeine or dextromethorphan, followed by peripherally acting agents (e.g., levodropropizine, benzonatate, or levocloperastine). In refractory cases, the neurokinin- 1 (NK1) receptor antagonist aprepitant reduced cough frequency in a randomized trial. Substance P, which activates NK1 receptors in vagal sensory pathways, appears to drive cough; aprepitant blocks this activation in preclinical models. Cough is a common and burdensome symptom in lung cancer, whether post-surgical or disease-related. This narrative review outlines a stepwise approach to evaluation and treatment, starting with cancer-directed therapy and supportive care, followed by evidence-backed antitussives. Emerging therapies like NK1 receptor antagonists show promise for refractory cases. High-quality trials are needed to further validate these approaches and integrate them into standard care to improve the quality of life of patients with lung cancer.<\/jats:p>","DOI":"10.4046\/trd.2025.0166","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T02:01:54Z","timestamp":1774317714000},"page":"391-402","update-policy":"https:\/\/doi.org\/10.4046\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Innovative Tools and Perspectives in Cough Management: Cancer and Cough"],"prefix":"10.4046","volume":"89","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6536-9763","authenticated-orcid":true,"given":"Juwhan","family":"Choi","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8693-5792","authenticated-orcid":true,"given":"Sung Yong","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2481","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-023-03235-y","type":"journal-article"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.15147","type":"journal-article"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.654797","type":"journal-article"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.13042","type":"journal-article"},{"key":"ref5","first-page":"257","type":"journal-article","volume-title":"The female preponderance to cough hypersensitivity syndrome: another clue pointing to the role of TRPV1 in cough","author":"Patberg","year":"2011"},{"key":"ref6","first-page":"116","type":"journal-article","volume-title":"Surgery for lung cancer: postoperative changes and complications: what the radiologist needs to know","author":"Burel","year":"2021"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-024-15012-6","type":"journal-article"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.08.54","type":"journal-article"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.21037\/qims-21-368","type":"journal-article"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol29010027","type":"journal-article"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2004.06.045","type":"journal-article"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1177\/10732748241255824","type":"journal-article"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/8840594","type":"journal-article"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1201658","type":"journal-article"},{"key":"ref15","first-page":"1557","type":"journal-article","volume-title":"The impacts of morning, daytime, and nighttime symptoms on disease burden in real-world patients with COPD","author":"Munoz","year":"2018"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1378\/chest.129.1_suppl.63s","type":"journal-article"},{"key":"ref17","first-page":"15","type":"journal-article","volume-title":"Afferent nerves regulating the cough reflex: mechanisms and mediators of cough in disease","author":"Canning","year":"2010"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-22-1757","type":"journal-article"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.1005404","type":"journal-article"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.04.176","type":"journal-article"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2002.34.1.3","type":"journal-article"},{"key":"ref22","first-page":"58","type":"journal-article","volume-title":"Epidemiology of lung cancer in Korea: recent trends","author":"Park","year":"2016"},{"key":"ref23","first-page":"193","type":"journal-article","volume-title":"Objective assessment of cough: listening to the patient\u2019s voice: a narrative review","author":"An","year":"2026"},{"key":"ref24","first-page":"477","type":"journal-article","volume-title":"Cough, a vital reflex: mechanisms, determinants and measurements","author":"Andrani","year":"2019"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-2024-2262","type":"journal-article"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1097\/spc.0b013e328352b6a5","type":"journal-article"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13040946","type":"journal-article"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00113603","type":"journal-article"},{"key":"ref29","first-page":"9","type":"journal-article","volume-title":"A cross sectional study to determine the prevalence of cough and its impact in patients with lung cancer: a patient unmet need","author":"Harle","year":"2020"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.10.003","type":"journal-article"},{"key":"ref31","first-page":"263","type":"journal-article","volume-title":"Revised Korean Cough Guidelines, 2020: recommendations and summary statements","author":"Joo","year":"2021"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1186\/1745-9974-6-9","type":"journal-article"},{"key":"ref33","first-page":"861","type":"journal-article","volume-title":"Symptomatic treatment of cough among adult patients with lung cancer: CHEST guideline and expert panel report","author":"Molassiotis","year":"2017"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102100","type":"journal-article"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(12)60776-4","type":"journal-article"},{"key":"ref36","first-page":"e15916","type":"journal-article","volume-title":"Effect of pregabalin for the treatment of chronic refractory cough: a case report","author":"Li","year":"2019"},{"key":"ref37","first-page":"167","type":"journal-article","volume-title":"Efficacy and safety of gabapentin in the treatment of chronic cough: a systematic review","author":"Shi","year":"2018"},{"key":"ref38","first-page":"83","type":"journal-article","volume-title":"Pregabalin as a pain therapeutic: beyond calcium channels","author":"Alles","year":"2020"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.2165\/11536200-000000000-00000","type":"journal-article"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-4159.2010.06625.x","type":"journal-article"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-024-02913-2","type":"journal-article"},{"key":"ref42","first-page":"2942","type":"journal-article","volume-title":"The efficacy of specific neuromodulators on human refractory chronic cough: a systematic review and meta-analysis","author":"Wei","year":"2016"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000244377.60334.e3","type":"journal-article"},{"key":"ref44","doi-asserted-by":"publisher","DOI":"10.1177\/1078155219870594","type":"journal-article"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2019.11.048","type":"journal-article"},{"key":"ref46","first-page":"737","type":"journal-article","volume-title":"Aprepitant for cough in lung cancer. a randomized placebo-controlled trial and mechanistic insights","author":"Smith","year":"2021"},{"key":"ref47","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctarc.2020.100278","type":"journal-article"},{"key":"ref48","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/151.3_pt_1.815","type":"journal-article"},{"key":"ref49","first-page":"323","type":"journal-article","volume-title":"Role of substance P in cough","author":"Sekizawa","year":"1996"}],"container-title":["Tuberculosis and Respiratory Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/e-trd.org\/upload\/pdf\/trd-2025-0166.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-trd.org\/journal\/view.php?doi=10.4046\/trd.2025.0166","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/e-trd.org\/upload\/pdf\/trd-2025-0166.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T08:18:31Z","timestamp":1782980311000},"score":1,"resource":{"primary":{"URL":"http:\/\/e-trd.org\/journal\/view.php?doi=10.4046\/trd.2025.0166"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,1]]},"references-count":49,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"URL":"https:\/\/doi.org\/10.4046\/trd.2025.0166","relation":{},"ISSN":["1738-3536","2005-6184"],"issn-type":[{"value":"1738-3536","type":"print"},{"value":"2005-6184","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,1]]},"assertion":[{"value":"2025-10-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-24","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-01","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}