Coughing Out Blood (Haemoptysis)

Prompt medical assessment is advised if haemoptysis occurs alongside:

• Persistent cough lasting more than two to three weeks
• Unexplained weight loss
• Progressive breathlessness
• Chest pain
• Recurrent episodes of bleeding
• Significant smoking history
• Age above 40 with new-onset respiratory symptoms

Massive haemoptysis, defined as large-volume bleeding or bleeding causing airway compromise, requires immediate emergency care.

Assessment of haemoptysis typically involves:

• Comprehensive clinical history and examination
• Chest radiography as an initial investigation
• Contrast-enhanced CT scan of the thorax for detailed anatomical assessment
• Sputum cytology or microbiological analysis where indicated
• Bronchoscopy for direct visualisation and localisation of bleeding source

In patients with risk factors for lung cancer, imaging plays a critical role in identifying suspicious pulmonary nodules, masses, or endobronchial lesions.

Early evaluation improves diagnostic accuracy and enables timely management.

Anybody can get lung cancer but most lung cancers are caused by:

• Smoking (90%) – active and second-hand smoke

Tobacco smoke contains more than 4,000 chemical substances, most of which have been identified to cause lung cancer. According to research, smoking 20 cigarettes per day increases the risk of lung cancer by 20-25 times compared to non-smokers. Vaping also consists of many detrimental chemical substances that can be linked to cancer.

Other causes of lung cancer include:

• Chronic obstructive pulmonary disease
• Air pollution from vehicles and factories
• Having lung diseases such as tuberculosis
• Exposure to asbestos and other carcinogens
• Occupational exposure to arsenic, chromium, nickel, aromatic hydrocarbon, ether etc.