Stage 4 nsclc adenocarcinoma metatasized 0 months now coughing and spitting up blood, requiring immediate blood transfusion. why?

Progression of dz: I am very concerned with the symptoms. That indicates perhaps now the disease has progressed more-especially with presence of significant anemia. There is a possibility that now the cancer has gone to the bone marrow and supress normal blood production. The cancer in the lung may have gotten bigger that's explaining presence of cough/spitting blood. Need treatment ( chemo and radiation th) d/w md.