What should you know about hemoptysis and lung cancer?

Blood may come from irritated airways, infection, bronchiectasis, a blood clot, medicines that affect clotting, or a tumour. Assessment considers the amount and appearance of blood, how long it has been present, smoking history, breathing symptoms, medicines, and examination findings. Tests may include chest imaging, blood tests, and examination of the airways.

Lung cancer can also cause persistent cough, chest discomfort, breathlessness, unexplained weight loss, or a hoarse voice. These symptoms have many possible causes, so they need assessment rather than self-diagnosis.

Arrange prompt medical assessment for any unexplained coughing of blood. Note when it began, whether it is streaked or free-flowing, and whether clots are present. Bring a list of medicines, especially anticoagulants, and describe chest pain, fever, breathlessness, or recent infection. Do not stop prescribed blood-thinning medicine without medical advice.

Call emergency services for more than a small streak, repeated bleeding, clots, severe breathlessness, chest pain, a fast heartbeat, blue lips, faintness, confusion, or difficulty speaking. Sit upright, avoid driving yourself, and follow the emergency team’s instructions while help is coming.

Where is the blood likely coming from? Which scan or airway test is needed? Could my medicines be contributing? What symptoms mean I should return immediately? If cancer is found, would genomic profiling change treatment choices?