There are many causes of coughing in someone who is over 40 years and who is a smoker, or has smoked regularly in the past, there is always a chance that the cough could be due to lung cancer. This risk is greater if they start to cough up blood and they should see their family doctor immediately.

The Department of Health has recently given guidelines to family doctors (GPs) suggesting that they should arrange an urgent referral with a chest specialist for anyone over 40 years who smokes or has done previously and has coughed up blood more than once.

Usually you should see the specialist within 2 weeks of this referral being made. The chest specialist  will ask your father about his symptoms and examine him. They will also do a chest x-ray. Most lung cancers that are causing symptoms, like coughing up of blood, will show up on a chest x-ray. Even if the chest x-ray does suggest there is a cancer there the specialist is likely to do some more tests to confirm it and decide what the best treatment should be. These tests may include:

• taking a sample of phlegm (sputum) to look at under the microscope

• passing a narrow flexible tube (bronchoscopy) into the lungs to look at the air passages and possibly take some tiny samples of tissue (biopsies) for examination.

• a detailed scan called a CT-scan.

If these tests confirm that there is a cancer in the lung then further treatment might involve an operation to remove it, or some radiotherapy or chemotherapy, depending on the type of lung cancer and the extent of it. So it is important for your father to see his GP because coughing up blood is a symptom that needs to be investigated as soon as possible