Hemoptysis

As the widespread use of asbestos-containing products lingers in recent memory, the effects of devastating exposure to airborne asbestos particles have become more prominent. The connection between the pervasive use of asbestos and, at the time, a seemingly innocuous and durable mineral, will mean more individuals will be diagnosed with mesothelioma over time. Between the widespread use of the product and the incubation period – sometimes as long as forty years – mesothelioma diagnoses should rise steadily over the next several years.
Along with expanding medical research into the causes and treatment of mesothelioma, understanding and recognizing the symptoms is important. Early recognition is tantamount to a better prognosis for mesothelioma cancer.
Most of the symptoms of mesothelioma are interconnected, though one of the most distressing symptoms is hemoptysis or coughing up blood. With early detection and and careful monitoring of developing symptoms, progressive hemoptysis can be prevented.
There are three types of mesothelioma affecting different parts of the body: pleural mesothelioma (lungs), pericardial mesothelioma (heart) and peritoneal mesothelioma (abdomen). Hemoptysis presents, mainly, with pleural mesothelioma.
After exposure, asbestos particles become attached to the lungs, and remain there for decades. With pleural mesothelioma, the particles instigate a cellular chain-reaction, causing the pleura or the lining of the lungs to become cancerous. If left undetected or untreated, malignant mesothelioma may develop.
Early detection is paramount and can prevent an additional life threatening condition. Understanding the underlying structure of the lungs can help determine the cause of hemoptysis or whether hemoptysis is actually present. In some cases, bloodied mucus is mistaken for hemoptysis.
Through the trachea or windpipe, air travels into the lungs through the bronchi. Within the bronchi, air disseminates into smaller bronchioles, ending at the alveoli or tiny air sacs, surrounded by blood vessels. At the alveoli, air is divided into oxygen or waste. Oxygen is absorbed into the blood and waste or carbon dioxide is exhaled.
Hemoptysis can originate in the trachea, bronchi or lungs. A thorough examination of the color and consistency of the expectorated or coughed up blood will determine the source. Generally, bright red blood is from the respiratory tract, where dark red blood is from the gastrointestinal tract. Most cases of hemoptysis are considered minor and non-life-threatening.
It can be hard to distinguish hemoptysis from other types of minimal, internal bleeding. Blood vessels and other blood carriers are extremely fragile and can easily rupture. Sometimes bleeding in the upper respiratory tract or regurgitated blood from the gastrointestinal tract can mimic hemoptysis. This “pseudohemoptysis” often signals a different type of illness, and does not typically last.
Bloodied mucus typically is present with acute or chronic bronchitis or pneumonia, and overall, differs significantly from hemoptysis. However, these illnesses and other lung-related diseases could cause minor hemoptysis. Occasionally, hemoptysis is self-regulating and benign: if an individual coughs too hard, the blood vessels can rupture, causing a trace amount of blood to be expectorated. These cases are usually one-time and resolve on their own.
Major or massive hemoptysis is distinguished by the amount of blood expectorated in a period of time, typically a twenty-four hour period. Massive hemoptysis is life threatening where more than six hundred milliliters or two-and-a-half cups of blood are expectorated, which can lead to asphyxiation. Due to the volume coughed up, the lungs can become full of blood.
Minor hemoptysis caused by coughing and shortness of breath can signal a more severe, underlying health issue. As other early symptoms of mesothelioma cancer present – including shortness of breath, pain in the chest, coughing – hemoptysis may begin, slowly and irregularly. A little blood in expectorated mucus should not be ignored, especially if it becomes more persistent and the consistency changes.
If detected and treated early, progression of minor to major hemoptysis can be prevented. However, with pleural mesothelioma, massive hemoptysis can signal the rapid carcinogenesis or the transformation of normal cells into cancer cells.
Asbestos products are all but gone, but the damage left behind is devastating. The recent rise of mesothelioma cases is staggering but not surprising, considering the latency period associated with the disease and the rampant use of asbestos at one time in our Nation’s history.
With any individual expectorating blood should be seen by a medical professional immediately.