The most common and one of the first symptoms that attract attention and concern patients with lung cancer is coughing. The cough has a reflex character and its implementation is provided by the so-called “irritation receptors” that are found between the cells of the integumentary epithelium of the bronchi and form peculiar “tussogenic zones” within the largest of them. Their irritation or involvement in the pathological process leads to the appearance of cough. depending on the extent of the blastomatous changes, the nature of the spread of the tumor within the bronchus of medium or large caliber, the cough symptom accordingly changes. Initially, when a growing tumor, most often a central one, only upsets and complicates the contractile, motor-evacuation function of the bronchi, coughing, once it appears, soon acquires an episodic character, is rare. For heavy smokers, this usually goes unnoticed, not different from the so-called “smokers cough” habitual for them. Later, with the germination of the bronchial wall, the narrowing or overlapping of its lumen by a tumor, a dry cough becomes more permanent, stable. Subsequently, it becomes harsh and even painful, often depriving of normal sleep and rest. when the central tumor spreads to the main bronchus, especially with its endobronchial growth, against the background of a constantly restrained, suppressed cough, its episodes occur in the form of severe attacks, sometimes lasting about a minute. Such a cough is very characteristic of lung cancer and is called “barking”, “with an anguish”. As a rule, it does not give a feeling of satisfaction, eliminating the cause of it that caused it.

With the peripheral form of tumor growth, the appearance of a cough most often indicates its growth to one of the nearby large bronchi. Then, subsequently, with the progression of blastomatous changes in the lung, this symptom of peripheral cancer becomes similar to its manifestations in central forms of tumor growth.

Cough may be accompanied by sputum. Its nature in patients with lung cancer is most often determined by the duration of the process. Initially, with the development of bronchial stenosis, the patient coughs up mainly mucous, foamy sputum. This is due to catarrhal inflammation of the bronchial mucosa in and around the lesion. In the future, the amount of sputum increases, it becomes mucopurulent, which is associated with the development of secondary bronchitis or inflammatory changes in the affected part of the lung.

Cough and hemoptysis in the form of streaks of red blood, spitting sputum, diffusely stained with blood or containing small inclusions of dark, altered blood, we observed in 15-20% of patients with lung cancer. As a rule, once it appears, this symptom can completely disappear for several days and even a longer period of time, which usually relieves the anxiety that arose in patients. However, the progression of the tumor process invariably leads to

recurrence of hemoptysis. From episodic, it becomes more permanent, regular. The basis of these changes is the tumor destruction of the capillary and larger vessels of the bronchial wall, formed here by the bronchial arteries. As the tumor develops, it destroys nearby structures with a violation of the integrity of the blood vessels, the intensity of hemoptysis can increase. In the late, terminal stages of the disease, almost all sputum discharged with cough acquires characteristic changes, sometimes called “raspberry jelly,” or pulmonary hemorrhage develops.