A 55-year-old male presents with a daily headache that is persistent upon waking up and improves as the day goes on. He also reports a chronic cough and unintentional weight loss. What is the likely diagnosis and next steps?
In a middle-aged smoker with a daily headache worse in the morning, associated with chronic cough and unintentional weight loss, the possibility of lung cancer with brain metastasis should be considered. The headaches may be due to increased intracranial pressure from the metastatic disease. He needs an immediate CT or MRI of the head, and if lesions are found, further investigation to identify the primary site is warranted. Given his symptoms, a chest x-ray or CT scan may reveal a primary lung lesion.