Management of cough in advanced cancer

Cough is a common symptom in cancer, with causes that can be benign or malignant. When severe, it affects patients' quality of life and well being. Treatment begins with a detailed history and careful physical examination, followed by chest imaging. Managing cough is directed at correcting the reversible causes. Empiric treatment of cough is valuable in both reversible and irreversible causes. We prefer hydrocodone as first-line empiric treatment, but when the cough is resistant to this, our second-line therapy would be the addition or substitution of benzonatate. Bronchodilators, as well as corticosteroids, are commonly employed in our practice and can be useful in unsuspected bronchospasm.