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Forum Name: Miscellaneous Cancer Topics

Question: Spitting blood, dizziness, pains in chest and back

bedders - Fri Jan 05, 2007 8:22 pm

I have been spitting blood now for about 3 months. I constantly taste blood in my mouth and when I spit out I get pure blood (about 12 spits). This happens every time I spit and seems to getting worse. I also get pains across my chest and back in the same way you do when you have infection, and also get terrible head pressure and dizziness, sometimes leading to nosebleeds. I have been to A&E on two occasions, had a sinus CT scan, 3 chest x-rays and an Endoscopy (to see if the blood is coming from my stomach). Nothing has been found. I am waiting a neurology appt. re the dizziness. The whole thing feels head and lung related but the docs keep telling me my chest is normal. Anyone get any advice pls - I'm going out my mind with worry.

Dr. Tamer Fouad - Thu Feb 15, 2007 3:35 pm

Hello, Please specify your age, sex and medical history as indicated in the forum rules. The first step is to establish that your complaint is indeed hemoptysis. This is defined as Coughing blood or spitting blood that originates in the lung or bronchial tubes. This can usually be established both clinically and by way of a sputum analysis. In some cases it may be less obvious and may require Endoscopy to rule out GIT origin. Once true hemoptysis is suspected investigations will tend to focus on the respiratory tract. The presence of Cough favors lower respiratory tract disease whereas its absence favors upper respiratory tract disease. Spitting clear blood favors an upper respiratory source but does not exclude lower respiratory tract sources especially if the bleeding is brisk. Are you a smoker? Are you taking any blood thinners? These are some of the risk factors that should be excluded. It is common for smokers to have mild hemoptysis recurring over a prolonged period of time. Environmental exposures to certain chemicals puts you at risk of other types of lung disease including cancer. A history of recent travel to an area in which TB or parasitic diseases are endemic is another point to be considered. Examination should also include examination of Lymph nodes in the neck. After a careful examination a chest x-ray is ordered. If the x-ray findings are not clear or fails to help reach a diagnosis then a CT scan and a Bronchoscopy is in order. This is especially true in cases that are at high risk of malignancy. This includes patients that are over 40 years of age, male, heavy smokers (over 40 pack years) and those with a frequency of more than one attack of hemoptysis a week. A proper evaluation will also include lab tests and a blood coagulation profile. Best regards,

bedders - Fri Feb 16, 2007 7:43 pm

I am 35, male and a non-smoker and don't take blood thinners. I don't work with chemicals and have not visited any countries in the last year. I don't Cough any blood, only spit blood. All of the tests that you mention have been done. A CT scan of the sinuses, 3 x-rays of the chest, an endscopy and I'm now being sent for a CT Scan of the brain. Only things not had done on your list is coagulation test and lab tests, unless by that you mean blood tests. Thansk for your reply. If you have any more info, please let me know

Dr. Tamer Fouad - Sat Feb 17, 2007 11:13 am

Hello, I was referring to a CT of the chest not the sinuses and a Bronchoscopy not an Endoscopy. Regarding the coagulation tests and other blood coagulation and clotting tests I was referring to tests such as INR, Platelet counts, Clotting time and the like. Best regards,

bedders - Sun Feb 18, 2007 2:31 pm

Thanks for clearing this up. I have made comments about CT of the chest and an Endoscopy. Doctors said that was only done if x-ray showed anomaly. I mentioned to my GP about clotting, platelets etc. as I had read up on this. They said my symptoms didn't match up with that type of problem. Oh, and one more thing - I suffer from this paid under my right rib. Always worse when the bleeding and head pressure is bad. GP's said the two areas cannot be connected, yet one is bad when the other is. Area shwoed nothing on x-ray, and liver/kidneys showed as working ok. I trust why you can see how this is driving me mad.

Dr. Tamer Fouad - Mon Feb 19, 2007 10:12 am

Yes I understand your concern. Unfortunately, I would be unable to evaluate the clinical significance of your symptoms. You could always ask for a second opinion - if another doctor (preferably a pulmonologist) also says you do not need further investigation then all you can do is observe. Should you develop new symptoms or the blood frequency/volume increase, then you should contact your doctor immediately. If the Coughing of blood is significant enough for them to get an Endoscopy done then it may warrant a CT of the chest/ Bronchoscopy (Endoscopy of the lung bronchi). Its just a thought.

bedders - Mon Feb 19, 2007 11:03 am

Dr. Tamer Fouad wrote: Yes I understand your concern. Unfortunately, I would be unable to evaluate the clinical significance of your symptoms. You could always ask for a second opinion - if another doctor (preferably a pulmonologist) also says you do not need further investigation then all you can do is observe. Should you develop new symptoms or the blood frequency/volume increase, then you should contact your doctor immediately. If the Coughing of blood is significant enough for them to get an Endoscopy done then it may warrant a CT of the chest/ Bronchoscopy (Endoscopy of the lung bronchi). Its just a thought. I think that is where the problem lies in that I never Cough up any blood - only spit blood. And because I have 3 or 4 symptoms, all of which they say are not related, this leads them to say it must all be 'in my head'. Is there anyway the CT of the sinuses could have missed something, as the head pressure, dizziness and blood happen at the same time and all feel as though they are in this area?

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