Lung cancer may masquerade as hay fever

November 27, 2020 2 min read

Lung cancer may masquerade as hay fever


A cough is a symptom that occurs in both hay fever and lung cancer. The former is an annoying condition, while the latter is often life-threatening. So it is concerning to learn that a cough that is thought to be caused by hay fever may sometimes, instead, signify the early stages of lung cancer.

Such a case was highlighted in the national press recently, where a 53-year old woman reported feeling chesty and wheezy and assumed it was the hay fever that she had been suffering from for the previous three years. In fact, she had early lung cancer and the diagnosis was only made when another typical symptom of lung cancer (clubbed fingertips and nails, where the nails feel odd and spongy and fingertips may be swollen and slightly blue) was spotted by a chiropractor, visited for an unconnected campaign. Referral to the GP, who was already treating her for fatigue (another possible symptom of cancer) immediately triggered an investigation and a chest X-ray revealed a tumour in the right lung. Fortunately, the story has a happy ending, as the tumour was removed, the patient had chemotherapy and is alive and well five years on.

This woman was very lucky that the chain of chance led to a diagnosis early enough to cure her. The five-year survival rate for lung cancer is only 9 per cent in the UK, making it the most common cause of cancer death among both men and women. There are 35,000 new cases of lung cancer a year in the UK, making it the second most common cancer, after breast cancer. It is most common among the over-50s and the biggest increases in the last four years have been among the over-75s, because of the ageing of our population.

Lung cancer can be hard to spot and is sometimes confused with persistent colds, flu and allergies such as hay fever, this may lead to the patient not taking a cough seriously enough and delaying a visit to the doctor. The key differences between hay fever and lung cancer are:

  • Hay fever occurs in bouts and it varies from day to day (depending upon allergen exposure). It should be relieved by antihistamine medication.
  • Lung cancer symptoms, including a cough, do not vary with season or allergen exposure. They get worse over time.

Symptoms of lung cancer to look out for include:

  • A cough lasting three weeks or more
  • Breathlessness
  • Fatigue
  • Chest pain
  • Shoulder pain
  • Numbness or weakness in the hand
  • Clubbing of the nails/fingertips
  • A chest infection that does not clear up

Lung cancer is a particular problem in the UK because survival rates are lower than in the rest of Europe. Over two-thirds of patients are not diagnosed till a late stage, when curative treatment may no longer be possible. It may be that some of these patients are reluctant to see their doctor because they think ‘it’s only my hay fever flaring up’. But if you are in any doubt, it’s always best to be sure. Remember, a persistent cough is not always hay fever.

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