Most persistent coughs have a common, manageable cause — a virus that has left airway irritation behind, gastric reflux, or post-nasal drip. But a cough that has lasted more than three weeks without a clear explanation is worth investigating properly. Some thoracic causes — including early lung cancer — are best found early, when the most treatment options are available. Dr Lawrence Okiror, Consultant Thoracic and Robotic Surgeon (GMC 6150382), sees patients at London Bridge Hospital within 2–3 days. If the cause turns out not to be surgical, he will tell you so and refer you to the right colleague. The goal is a clear answer, not a surgical one.
Last reviewed: April 2026 · Dr Lawrence Okiror FRCS(CTh) FRCSEd(CTh) · GMC 6150382
A cough that has lasted more than three weeks without a clear explanation — no recent infection, no obvious cause — is worth a specialist review. In a smoker or ex-smoker, the threshold is lower. A chest X-ray is not sensitive enough to rule out all thoracic causes — a CT scan is more reliable.
Lung cancer in people who have never smoked is a recognised and growing clinical picture. These cancers respond well to targeted treatments when found early. A persistent cough in a never-smoker without an obvious explanation is worth investigating rather than dismissing.
Many persistent coughs have non-surgical causes. If investigation shows something better managed by a respiratory physician or medical oncologist, Dr Okiror will tell you so and refer you directly to the right colleague at the same institutions. You get a clear answer either way.
Most persistent coughs have a common, treatable cause — the aftermath of a chest infection, gastric reflux irritating the airway, asthma, or mucus dripping from the back of the nose. These are all manageable. The less common but important causes are chest-specific: a lung nodule, fluid around the lung, a problem in the central airways, or — less commonly — lung cancer.
Yes. Lung cancer in people who have never smoked is increasingly recognised as a distinct condition, often driven by specific genetic changes that respond well to modern targeted treatments. GSTT, where Dr Okiror operates, has an active research programme on this. Never-smoking history does not rule out a thoracic cause — it just changes what that cause is likely to be.
If investigation reveals a cause that is better managed by a respiratory physician or medical oncologist — such as asthma, reflux, or a medical lung condition — Dr Okiror will tell you so directly. He will refer you to a trusted colleague at GSTT or London Bridge Hospital who shares his commitment to patient-centred, unhurried care. The referral is direct and personal, not a generic letter.
No. You can contact the practice directly and be seen within 2–3 days at London Bridge Hospital. If you have already had a chest X-ray or CT scan done, bring the images. Dr Okiror reviews them personally at the first appointment and can give an informed assessment without any duplication of tests. New consultations from £250.
Once common causes have been excluded — no reflux, no post-nasal drip, not on an ACE inhibitor medication — the following thoracic causes are the ones a specialist looks for. All are identifiable on CT scan and all are treatable.
A nodule or tumour in the lung or central airways can cause a cough. This is the most important cause to rule out — not because it is the most common, but because finding it early, when it is still small, makes a significant difference to the treatment options available. CT scan is the right investigation — a chest X-ray can miss it entirely.
Lung nodule & cancer →A narrowing, growth, or inflammation in the trachea or main bronchi (the large central airways) causes a distinctive persistent cough — often dry with a slightly barking quality. A bronchoscopy (a small camera in the airway) diagnoses this and can often treat it at the same procedure. Dr Okiror leads the Central Airways Service at GSTT.
Central airways →A build-up of fluid between the lung and the chest wall (pleural effusion) causes irritation and a persistent cough, usually alongside breathlessness. The fluid can be drained, the underlying cause identified from the fluid analysis, and the appropriate treatment started. This is a straightforward procedure. Pleural disease →
Chronic airway inflammation from emphysema or COPD causes a persistent productive cough, often with breathlessness on exertion. For patients whose symptoms are not controlled by inhalers, there are further specialist options including endobronchial valve therapy and lung volume reduction surgery. Emphysema treatment →
“If investigation finds a cause that is not surgical — a medical lung condition, gastric reflux causing a chronic cough, or a pattern better managed by a respiratory physician or medical oncologist — I will tell you so directly at the consultation. Where appropriate, I refer to specialist colleagues at GSTT and London Bridge Hospital who share my commitment to patient-centred care and honest, unhurried discussion of options. These are colleagues I work with closely at both institutions. The referral is direct and personal.”
— Dr Lawrence Okiror, Consultant Thoracic and Robotic Surgeon
Questions most commonly asked by patients with a cough that has lasted more than three weeks.
Book an Assessment →Or call Jo Mitchelson:
020 7952 2882
No GP referral required. Private appointments at London Bridge Hospital within 2–3 days. Dr Okiror will review your imaging personally and tell you clearly what the investigation shows — and what, if anything, needs to happen next.
Jo Mitchelson, Private PA · 020 7952 2882 · pa@lungsurgeon.co.uk
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