Can Chemotherapy Cause Cough as a Side Effect?

Yes, a cough can occur during cancer treatment, although the cause is often multi‑factorial (medicines, infections, radiation to the chest, or inflammation of the lungs). Chest radiation given with chemotherapy is well known to trigger cough or shortness of breath during treatment. ^[1] Chemotherapy also lowers white blood cells and immunity, which can make infections like bronchitis or pneumonia more likely and lead to cough. ^[2]

Why a Cough Happens During Treatment

• Chest radiation effects: Radiation to the chest, especially when combined with chemotherapy, commonly causes cough or shortness of breath during the treatment period. ^[1]
• Lowered immunity and infections: Many chemotherapy regimens suppress bone marrow, which reduces white blood cells; this increases infection risk and can lead to cough, fever, and breathing symptoms. ^[2]
• Drug‑related lung inflammation (pneumonitis): Some anticancer drugs can inflame lung tissue; management typically starts with stopping the offending drug and supportive care, and steroids are considered for more severe cases. ^{[3] [4] [5]}

When to Contact Your Care Team Urgently

• New or worsening cough with fever, chills, or shortness of breath, which may suggest infection during lowered immunity. ^[2]
• Persistent or progressively worsening cough during chest radiation or combined chemo‑radiation. ^[1]
• Chest pain, low oxygen levels, or rapid breathing that could indicate significant lung inflammation. ^{[3] [4]}

Practical Ways to Cope at Home

These strategies can make you more comfortable while your team evaluates the cause:

• Keep air moist: Using a humidifier and increasing fluid intake helps thin mucus and soothe a dry, irritated throat. ^[6]
• Gentle breathing and posture: Breathing exercises help move secretions, and staying upright can make it easier to clear phlegm. ^[6]
• Cough etiquette and hand hygiene: Cover your cough and clean hands to reduce germ spread, which is especially important during treatment. ^{[7] [8]}
• Ask about safe cough remedies: Your clinician can advise which cough medicines are appropriate; low‑alcohol options are preferred after chest radiation. ^[9]
• Avoid triggers: Try to avoid smoke, strong fragrances, and air pollutants that can worsen cough. ^[10]

Medical Treatments Your Team May Use

Treatment depends on the cause identified by your clinicians:

• Infection management: If a bacterial infection is suspected, antibiotics may be prescribed. ^{[6] [11]}
• Airway inflammation/bronchospasm: Inhalers that open airways and reduce airway inflammation can be used for cough related to asthma‑like airway irritation. ^[6]
• Drug‑induced pneumonitis: Holding or stopping the causative agent is typical; corticosteroids are often used for moderate to severe cases, supported by oxygen and other supportive measures as needed. ^{[3] [4] [5]}

What Your Care Team May Check

To pinpoint the cause, clinicians may consider:

• Symptom timeline relative to chemo and/or chest radiation. ^[1]
• Signs of infection during periods of low white blood cells caused by chemotherapy. ^[2]
• Imaging (chest X‑ray/CT) and sometimes pulmonary function tests when drug‑related lung toxicity is suspected, followed by individualized decisions on pausing therapy and starting steroids. ^{[3] [4]}

Key Takeaways

• A cough during chemotherapy and radiation is not uncommon and can stem from airway irritation, lowered immunity with infection, or less commonly, drug‑related lung inflammation. ^{[1] [2]}
• Simple measures like humidification, fluids, and trigger avoidance can help, but new or worsening symptoms especially with fever or shortness of breath should prompt timely medical review. ^{[6] [9]}
• Management is tailored: antibiotics for infections, inhalers for airway irritation, and possible treatment changes and steroids for drug‑induced pneumonitis. ^{[11] [6] [3] [5] [4]}

Would you like to tell me if you’re currently getting chest radiation or having fever with the cough?