eg, it could be 'ccache cc'

FWIW, the C/Makefile.PL in Inline-0.45 seems to do a pretty good job of finding the C compiler (albeit rather kludgily).
I don't think it detects 'ccache cc', however.
Here's a C/Makefile.PL that should also detect 'ccache cc', though it has yet to be run by the intrepid cpan testers:

use strict;
use ExtUtils::MakeMaker;
use Config;
use File::Spec;

my ($cc, $exe) = @Config{'cc', '_exe'};
$cc =~ s/\s+-.+$//; #remove possible trailing options
my $comp = (split /\./, $cc)[0];

my $found = 0;
my $delim = $Config::Config{path_sep};

if ($cc =~ m|/:\[|) {
    $found = -f "$comp$exe";
}

# $Config{cc} might be something like '/some/place/cc'
elsif ($cc =~ m|/|) { 
    $found = -f "$comp$exe" || -l $cc;
}

# $Config{cc} might be something like 'ccache cc'
elsif ($cc =~ m|ccache|) {
    my @cc = split /\s+/, $cc;
    $found = -f "$cc[0]$exe" || -l $cc[0];
    if($found && $cc[1]) {$found = -f "$cc[1]$exe" || -l $cc[1]}
}

else {
    my $comp = (split /\./, $cc)[0];
    for my $lib (split $delim, $ENV{PATH}) {
    $found = -f File::Spec->catfile($lib,"$comp$exe") and last;
    }
}

print <<END;

Inline::C is packaged with Inline.pm because it is the most commonly u
+sed
Inline Language Support Module (ILSM). 

See also: Inline::ASM, ::Awk, ::BC, ::Basic, ::Befunge, ::CPP (C++), :
+:CPR,
          ::Foo, ::Guile, ::Java, ::Octave, ::PERL, ::Python, ::Ruby, 
+::TT, 
          ::Tcl and ::WebChat.

Config.pm indicates that your version of Perl was built with this C co
+mpiler:

    $cc

END

if ($found) {
    print <<END;
I have located this compiler on your system:

END
}
else {
    print <<END;
I cannot locate this compiler on your system.

You can install Inline.pm without installing Inline::C. But you'll
need to install another Inline language module (like Inline::Java for 
instance) to actually make use of it. 

If the aforementioned C compiler really is on your system, please make
+ sure
it can be found in the PATH and then try running this program again. O
+r if
you think I made an error searching for this compiler, simply answer '
+Y' to
the next question.

END
# '
}

my $answer = '';
my $default = $found ? "y" : "n";
while (1) {
    $answer = prompt ('Do you want to install Inline::C?', $default); 
    last if $answer =~ /^(y|yes|n|no)$/i;
}

if ($answer =~ /^(y|yes)$/i) {
    WriteMakefile(
                  NAME => 'Inline::C',
                  clean => {FILES => '_Inline_test'},
                 )
}
else {
    open MF, "> Makefile" or die "Can't open Makefile for output";
    print MF <<'END';
all::
test::
clean::
END
    close MF;
}
[download]

Cheers,
Rob