Hemoptysis, cough, and pulmonary lesions

When evaluating patients with hemoptysis, it is important to determine whether the bleeding is massive and if the airway is secure. The treatment options used to control bleeding originating from the lung include medical management, bronchial lavage, embolization of bronchial arteries, and surgery. Critical in treating patients with lung cancer is determining the clinical stage. Patients with stage I and stage II non-small-cell carcinoma are best treated with surgical resection, while patients with stage IIIA non-small-cell carcinoma should receive chemotherapy prior to surgical resection. More advanced lung cancer is treated with chemotherapy with or without radiotherapy. Basic guidelines for the evaluation, staging, and treatment of lung cancer are highlighted (see Algorithm 13.1).