CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Palliative cancer care - cough - Management
How should I investigate a person with cough in palliative care?
- The appropriateness of investigation and treatment should be weighed against the prognosis, the likely benefit of treatment, and the person's wishes.
- The exact investigations requested will depend on the clinical assessment (e.g. chest X-ray if pleural effusion is suspected).
Clarification / Additional information
- It is assumed that individuals with an established diagnosis of malignancy will have been previously referred and investigated in secondary care.
- Investigations which may be carried out in secondary care include:
- Computed tomography/magnetic resonance imaging to assess for lymphangitis carcinomatosa [Ahmedzai, 2004].
- Ventilation/perfusion scan to exclude pulmonary embolism [Ahmedzai, 2004].
- Bronchoscopy, although this is rarely necessary once a diagnosis of cancer is made [Ahmedzai, 2004].
- Swallowing evaluation may be necessary if aspiration is suspected [Estfan and LeGrand, 2004].
- The person's wishes and their stage of illness will determine whether investigations to find the cause of the cough are appropriate [International Association for Hospice and Palliative Care, 2004].
Basis for recommendation
© NHS Institute for Innovation and Improvement