Lung cancer and persistent cough

[suzanne L.]

About 8 weeks ago, I came down with a cough that persisted. I went to my doctor after about 3 weeks of the cough - he specializes as an internist/pulmonologist, and at the time he said "winter cough". He did not want to do a chest xray even though I asked him about it - I was an intermittent social smoker in my 20s(10 cigarettes here and there, never a regular smoker)  and last had a cigarette 10 years ago. The cough persisted, so at 6 weeks I went back - he repeated to say no chest x ray required, since I was not a current active smoker, and  I was never a regular "pack a day" smoker. He is a well-respected pulmonologist in New York City. He did give me antibiotic and Asmanex. That was about 2 weeks ago and the cough seems to have gone away - I do feel like my airways are on "alert" more than usual - I feel like I have a slight urge to cough, but it never culminates into a cough. A few questions:

- everything I read says to get a chest x ray for persistent cough...especially if you have ever smoked at all. Why would a very well-regarded lung specialist disregard that?

- wouldn't a cough cause by something ominous like lung cancer get worse, not better?  Is there a typical "lung cancer" cough description. Would a chronic cough caused by something ominous, by its nature, be involuntary - e.g. you could not suppress it or control it?

I am 42 year old female in otherwise very good health

[National Jewish]

Getting a chest x-ray for the evaluation of a chronic cough may not be the first thing a physician does. Treating, as you have been treated, is probably the most common approach.  Coughing from lung cancer does not get better with simple therapies and that is the usual reason for getting more tests, when the cough persists.  There is no typical cough for any specific type of cause of cough, except croup and whooping cough.