Coughing Up Blood

[DDOT]

I need guidance or help from you guys. My husband, age 70, was diagnosed  6/1/2018 with Stage IV NSCLC. He has had 6 infusions of Keytruda + Alimta + 4 of Carboplatin. His lung function test in July was nearly perfect. He has no history of coughing, but since the weather has gotten much colder, for the last 2 weeks and he has been outside for short periods of time, he has a deep cough and starts to cough up blood. Not in great amounts but it usually takes 45 minutes to an hour to stop. It's red with clotted blood or some kind of tissue in it. The first time, 2 weeks ago, we called his Oncologist who was on call and he said take him to the ER. We did, they ran bloodwork and did chest xray and also sent results to the Oncologist on call and they discussed it. They sent my husband back home, unless he is losing a larger amount of blood and it is bright red, we were told not to worry. He has done this twice since and again today. What he coughs up onto tissues looks like fresh Red blood to me and adds up to 1/2 kitchen trash can of tissues each time. And I am not comfortable with waiting for a greater volume to start, we are 1 hour's drive from the ER at the hospital where he is being treated. We've never dealt with anything like this before and I'm worried and not comfortable with their theory of what constitutes a medical emergency but my husband doesn't want to seem like we're crying wolf. Am I over reacting? For those of you who have had lung cancer or any who still do, is coughing up blood just a result of treatments or worsening or progression of his cancer? Should I call the Oncologist AGAIN?

[BridgetO]

Yes, call the oncologist agiain! If they tell you not to worry, ask why not. This doesn't seem normal. 

[Tom Galli]

DDot,

Welcome here.

I had the same symptom as your husband.  My tumor filled the main stem bronchus of my right lung and was intruding into my trachea.  That intrusion is what triggered my coughing reflex and the excessive coughing produced blood.  In my case, this led to my lung cancer diagnosis.  

I can't give a medical answer as to how serious his coughing is but I can tell you that I waited about 6 to 8 weeks until a treatment plan was established and during that waiting period, I'd cough and produce blood.  In discussion with my doctors, I was told there was little they could do until I started treatment which did significantly shrink my tumor and I stopped coughing.  Your husband is in treatment but your doctor is aware of his symptom.  I'd call the practice on Monday and make another report about his condition.

Also, I'd try and keep him from coughing.  During the spring and fall when the pollen season sets in, I take a steam shower (run very hot water that produces steam, and stand in the shower). The steam soothes my airway and relieves congestion and therefore the desire to cough.  I also use Halls cough drops, the citrus variety, to again soothe my throat.  

It is interesting that Keytruda, an immunotherapy drug, often produces inflammation in the tumor sites and this inflammation could be  what is causing his cough.  I do hope it resolves.

Stay the course.

Tom

[Rower Michelle]

Hi DDOT

Tom & Bridget are correct. Keep on the oncologist.  My coughing spasms increased after my first round of the same protocol.   We had trash bags in every room! 

I found a link on YouTube about Belly Breathing (for COPD) and this seemed to help if I did it for ten minutes a day lying down. 

Even though I hated to do it- I took a short acting codeine based cough syrup every six hours. It helped reduce the frequency & severity.  

Michelle

[DDOT]

41 minutes ago, BridgetO said:

Yes, call the oncologist agiain! If they tell you not to worry, ask why not. This doesn't seem normal. 

Thank You !! 🙏 I don't think it seems normal either. He's been in treatment since 7/13/2018. Thank you for the quick response. I guess, for now, we're in a holding pattern because he doesn't want to feel like he's wasting their time. He's a very independent guy. I think that ER visit kind of made him feel like he was over reacting. But SOMEONE in that Oncologist's office will be answering ALL my questions this week, he gets a CAT Scan Tuesday and sees the Oncologist before treatments Friday, yes Black Friday, if not BEFORE. This kind of thing is scary out here in rural farmland.

[Rower Michelle]

I have learned to reorient my expectations about visiting the ED.  When it comes to lung cancer there is no such thing as over reacting. 

 

[DDOT]

1 hour ago, Tom Galli said:

DDot,

Welcome here.

I had the same symptom as your husband.  My tumor filled the main stem bronchus of my right lung and was intruding into my trachea.  That intrusion is what triggered my coughing reflex and the excessive coughing produced blood.  In my case, this led to my lung cancer diagnosis.  

I can't give a medical answer as to how serious his coughing is but I can tell you that I waited about 6 to 8 weeks until a treatment plan was established and during that waiting period, I'd cough and produce blood.  In discussion with my doctors, I was told there was little they could do until I started treatment which did significantly shrink my tumor and I stopped coughing.  Your husband is in treatment but your doctor is aware of his symptom.  I'd call the practice on Monday and make another report about his condition.

Also, I'd try and keep him from coughing.  During the spring and fall when the pollen season sets in, I take a steam shower (run very hot water that produces steam, and stand in the shower). The steam soothes my airway and relieves congestion and therefore the desire to cough.  I also use Halls cough drops, the citrus variety, to again soothe my throat.  

It is interesting that Keytruda, an immunotherapy drug, often produces inflammation in the tumor sites and this inflammation could be  what is causing his cough.  I do hope it resolves.

Stay the course.

Tom

Thanks, Tom. I do value what you've learned and thanks for your suggestions. I'm trying to keep him as quiet as possible and my niece has gone to pick up some Hall's cough drops. I've filled every RX the Oncologist has written but never thought about cough drops. I am calling the office first thing Monday morning or before if this doesn't stop. Today it's lasted almost 3 hours and not stopped yet. But the amount of blood with each cough has not increased. The ER physician said inflammation and swelling could be part of the problem. He hasn't tried the steam shower yet because I'm trying to keep him quiet. Thank you so much for being there on a Saturday afternoon, I was praying you would see my post. I'm staying the course. 

[DDOT]

1 hour ago, Rower Michelle said:

Hi DDOT

Tom & Bridget are correct. Keep on the oncologist.  My coughing spasms increased after my first round of the same protocol.   We had trash bags in every room! 

I found a link on YouTube about Belly Breathing (for COPD) and this seemed to help if I did it for ten minutes a day lying down. 

Even though I hated to do it- I took a short acting codeine based cough syrup every six hours. It helped reduce the frequency & severity.  

Michelle

Thanks for your reply. I am definitely staying on the Oncologist and writing down more questions today. My husband had no history of coughing or any COPD. There's no way he can lie down while he's coughing like this and bringing up mostly blood little mucous. This time is lasting longest yet but cough seems to be easing somewhat. I thought about RX cough syrup but I wondered if it helped him more to get this crud and blood out of his lung. We may try the breathing and cough syrup after this episode eases off. I don't think I'm over reacting either but he is the patient unless I know I must step in. Again, thank you for your replies.