Right Chest Pain: Causes, Concerns, and Next Steps - Pulmonology

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Understanding right chest pain can be complex, especially given your history and the symptoms you've described. It's important to approach this systematically, considering both your medical history and the nature of your symptoms.

Firstly, you mentioned that you have been smoking for about ten years and have been diagnosed with periodontal disease. Smoking is a significant risk factor for various respiratory conditions, including chronic obstructive pulmonary disease (COPD) and lung cancer. The presence of blood in your cough, even if it is just a few streaks, is concerning and warrants further investigation. Blood in sputum can arise from various sources, including the lungs, throat, or even the gastrointestinal tract, and should not be ignored.

Your description of the right chest pain, particularly the tightness and discomfort near the axilla (armpit), could be related to several factors. Since you noted that deep breathing does not exacerbate the pain, this might suggest that the pain is not originating from the lungs or pleura (the lining around the lungs). Instead, it could be musculoskeletal in nature, possibly related to muscle strain or tension, especially if you have been experiencing discomfort in your back as well.

The fact that you have undergone extensive testing, including X-rays, CT scans, and other evaluations, is reassuring. These tests are crucial in ruling out serious conditions such as lung cancer, heart disease, or significant pulmonary issues. If these tests have returned normal results, it is less likely that your symptoms are due to a malignancy or severe underlying disease. However, persistent discomfort can still be distressing and may require further exploration.

Regarding your question about whether lung cancer can cause pain upon pressing on the chest, it is generally not typical for lung cancer to cause localized pain in this manner. Lung cancer may cause pain if it invades surrounding structures or if there is associated pleuritic pain (pain due to inflammation of the pleura), but this is usually accompanied by other symptoms such as persistent cough, weight loss, or significant respiratory distress.

Given your ongoing discomfort and the anxiety it causes, it may be beneficial to consult with a pulmonologist or a thoracic specialist. They can provide a more focused evaluation of your respiratory health and may suggest additional imaging or tests, such as a bronchoscopy, if deemed necessary.
Additionally, considering your smoking history, it would be wise to engage in smoking cessation programs. Quitting smoking can significantly reduce your risk of developing serious health issues in the future, including lung cancer and cardiovascular diseases.

In summary, while your extensive testing has not indicated any serious conditions, the combination of your symptoms and smoking history suggests that a thorough evaluation by a specialist is warranted. They can help determine if there are any underlying issues that need to be addressed and provide guidance on managing your symptoms. Remember, it's essential to listen to your body and seek help when something feels off, especially with a history like yours.