Cough in palliative care

Cough- complex physiological mechanism that protects the airways and lungs by removing mucus and foreign matter from the larynx , trachea and bronchi and is under both voluntary and involuntary control

up to 40 % to 50 % of advanced cancer patients report cough up to 47 % to 86 % of lung cancer patients chronic cough ( > 8 weeks ) can be the presenting complain in over 65 % with lung cancer and 26 % of those with chronic lung disease in their last year of life also common in advanced chronic diseases as chronic obstructive lung disease , interstitial pulmonary fibrosis

Cough has a protective effect Cough can be provoked by stimulation of afferent C fibres ( chemoreceptors ) and A delta fibres (mechanoreceptors ) in the airways carried by the vagus nerve ie it can happen due to mechanical and chemical irritation of receptors in the respiratory tract Intact cough reflex requires ( a ) adequate respiratory muscles (b) closure of glottis (c ) dynamic compression of major airways ( d ) favorable mucus properties (e ) effective mucociliary clearance In cancer patients coughing can be less effective due to several factors as ( a )...