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Patients with lung cancer can provide treatment challenges for even the most skilled clinician. More than 90% of adults with lung cancer are symptomatic when they are diagnosed. According to Van Cleave and Cooley (2004), a minority of patients present with local symptoms related to their primary tumor, but most present with either nonspecific systemic or metastatic symptoms (see Table 1). A new cough or a change in a chronic cough is often the presenting and most distressing symptom in people with lung cancer. Cough is present in 65%-75% of patients with lung cancer, and more than 25% have a productive cough. Many lung cancers occur in central airways and may lead to ...