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P58 The Characterisation and Subjective Assessment of Cough in Lung Cancer and Mesothelioma: The “CLAIM” Study
  1. J Burnham1,
  2. O Buffin1,
  3. F Blackhall2,
  4. J Smith1,
  5. A Harle2
  1. 1University of Manchester, Manchester, United Kingdom
  2. 2The Christie NHS Foundation Trust, Manchester, United Kingdom

Abstract

Introduction Lung cancer (LC) and mesothelioma (M) are usually terminal, with poor 5-year survival. Therefore, symptom control is crucial. Cough is a significant problem with physical, psychological and social consequences. It has a broad aetiology and its physiological mechanisms remain unclear. Methods for its assessment are unreliable and available treatments are limited; the absence of valid quantification of cough prevalence and impact hinders the development of novel therapies. CLAIM evaluates the impact and prevalence of cough in LC and M using validated assessment tools.

Methods Consecutive outpatients attending two cancer centres over a 5 week period completed the Manchester Cough in Lung Cancer Scale (MCLCS) and a cough severity visual analogue scale (VAS). Demographic and clinical data were collected.

Results Patients were of advanced age (LC mean 66years, M mean 71years), predominately male (LC 54.9%, M 75.0%), with advanced disease (advanced non-small-cell LC 80.5%, extensive small-cell LC 71.4%). Those on treatment largely received palliative treatment (LC 89.7%, M 100%). The majority of patients were performance status ≥2 (LC 51.7%, M 60%). Cough was reported by 58% of LC patients (n = 224) and 43% of M patients (n = 60); painful cough was reported by 23% and 18%, respectively. LC and M patients felt their cough warranted treatment in 53% and 40% of cases. Cough was associated with breathlessness (LC 61.9%, M 63.6%), disrupted sleep (LC 47.8%, M 52.4%) and interrupted conversations (LC 64.6%, M 59.1%). There were moderate-strong correlations between MCLCS and VAS scores in all patient groups [non-small-cell (r = 0.68), small-cell LC (r = 0.66) and mesothelioma (r = 0.71), all p < 0.01].

Conclusions This is the first study comparing the prevalence and impact of cough in LC and M using validated cough-specific assessment tools, in a clinically representative population. Cough is common in these cancers and has marked effects on quality of life. In the absence of evidence-based treatments, it represents an unmet clinical need. The high prevalence of cough in M is counterintuitive, in view of the tumour location. The MCLCS and VAS correlations suggest these are complementary tools which perform reliably in these disease groups.

Abstract P58 Figure 1.

Correlation between VAS score and MCLCS score in lung cancer and mesothelioma.

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