Don't Assume Every New Symptom Is Aspergillosis

When you live with a long-term illness such as aspergillosis, it is easy to assume that every new symptom is part of the condition you already have. But sometimes a new symptom has a different cause, and recognising that possibility can make an important difference.

This subject was originally discussed at a National Aspergillosis Centre patient meeting, prompted by concerns about delayed cancer diagnoses and the importance of recognising symptoms early.

The message remains relevant today: having one serious illness does not prevent us from developing another.

Why chronic illness can make new symptoms harder to recognise

People with aspergillosis may already experience coughing, breathlessness, fatigue, chest discomfort and changes in appetite or weight.

These symptoms can fluctuate. Patients become familiar with managing them, and sometimes learn to tolerate changes that would previously have prompted a visit to their GP.

This creates a risk known as diagnostic overshadowing: new symptoms may be attributed to an existing diagnosis without sufficient consideration of other explanations.

Patients can make this assumption, but healthcare professionals can do so too.

A change in symptoms might reflect worsening aspergillosis, but it could also result from a bacterial infection, another respiratory condition, a medication side effect, heart disease or an unrelated illness.

Occasionally, it may be a sign of cancer.

Why early recognition matters

Many illnesses, including several types of cancer, are easier to treat when identified earlier.

Early diagnosis does not guarantee a particular outcome, but it can provide more treatment options and reduce the risk of complications.

This does not mean that every new symptom is serious. Most symptoms have causes other than cancer.

The important principle is to notice persistent or unexplained changes and seek appropriate assessment rather than automatically attributing them to aspergillosis.

Changes that deserve attention

Symptoms worth discussing with your GP or specialist include:

• A persistent change in your usual cough.
• Breathlessness that is noticeably worse or different from normal.
• Unexplained weight loss or loss of appetite.
• Persistent or unexplained pain.
• New lumps or swellings.
• Blood in your urine or stools.
• A persistent change in bowel habits.
• Unusual bleeding.
• New or changing skin lesions.
• Fatigue that is significantly different from your usual pattern.

These symptoms do not necessarily indicate cancer. They can have many explanations, including treatable conditions.

However, they should not automatically be dismissed because you already have a chronic illness.

Lung cancer and aspergillosis: overlapping symptoms

Lung cancer and pulmonary aspergillosis can sometimes produce similar symptoms, including coughing, breathlessness, chest pain, coughing up blood and weight loss.

Both can also cause abnormalities on chest imaging.

This does not mean that aspergillosis inevitably increases someone’s risk of lung cancer. Many patients have other risk factors or pre-existing lung conditions that need to be considered individually.

When symptoms or scans change unexpectedly, clinicians may need to investigate whether aspergillosis has progressed or whether another condition is responsible.

Read more in our article: Lung Cancer and Aspergillosis: When Symptoms and Scan Changes Need Careful Assessment.

Could medication be responsible?

Some medicines used to treat aspergillosis can produce symptoms that resemble other illnesses.

For example, antifungal medicines can affect liver function, cause gastrointestinal symptoms or interact with other medications.

One antifungal, voriconazole, is particularly associated with photosensitivity. Prolonged treatment has also been linked to an increased risk of certain skin cancers, especially squamous cell carcinoma.

This risk should not be generalised to every antifungal medicine.

Patients taking voriconazole should follow their clinical team’s advice about sun protection and report new or changing skin lesions.

Importantly, suspected side effects should be assessed rather than assumed to explain every new symptom.

Don’t forget routine screening

Living with a chronic respiratory condition should not mean missing routine NHS screening invitations.

Depending on your age, sex and eligibility, you may be invited for screening programmes such as:

• Bowel cancer screening.
• Breast screening.
• Cervical screening.
• Lung cancer screening for eligible people in the relevant age and smoking-risk groups.

Screening is intended for people who do not necessarily have symptoms. If you develop a concerning symptom, contact your GP rather than waiting for your next screening invitation.

Screening eligibility and arrangements can change, so consult the NHS screening information for current guidance.

What should you say to your GP?

Patients sometimes worry that they will be seen as overreacting, particularly when they already have frequent medical appointments.

It can help to explain exactly what has changed.

For example:

“I have aspergillosis and I am used to coughing and feeling tired, but this symptom is different from my normal pattern. I would like to make sure there isn’t another cause.”

Try to describe:

• When the change began.
• Whether it is persistent or getting worse.
• How it differs from your usual symptoms.
• Whether it affects sleep, appetite, activity or daily life.
• Any other new symptoms occurring at the same time.

A brief symptom diary can be useful, especially when changes develop gradually.

When should you seek urgent help?

Some symptoms need urgent assessment rather than a routine appointment.

Call 999 for severe breathing difficulty, severe chest pain or coughing up significant amounts of blood, particularly if accompanied by breathlessness, dizziness or feeling faint.

For other urgent concerns that cannot wait for a routine GP appointment, contact NHS 111 or an appropriate urgent care service.

The importance of looking beyond one diagnosis

Living with aspergillosis often means becoming highly knowledgeable about your own symptoms and treatment.

That experience is valuable. You may be the first person to notice when something has changed.

But familiarity can also make unusual symptoms seem normal.

The key message is simple: having aspergillosis does not mean that everything that happens to your health is caused by aspergillosis.

Recognising a change and asking for it to be investigated is not being unnecessarily anxious. It is an important part of looking after your health.

Further information

• NHS: Symptoms of cancer
• Cancer Research UK: Possible signs and symptoms of cancer
• NHS screening programmes
• Lung Cancer and Aspergillosis: When Symptoms and Scan Changes Need Careful Assessment

Last reviewed: October 2026. This article provides general patient information and does not replace individual medical advice.