lung diseases

2. Introduction:
Lung disease is any problem in the lungs that prevents the lungs from
workingproperly. There are three main types of lung disease:
 Airway diseases -- These diseases affect the tubes (airways) that
carry gases to the lungs. They usually cause a narrowing or
blockageof the airways. Airway diseases include asthma, COPD
and bronchiectasis.
 Lung tissue diseases -- These diseases affect the structure of the
lung tissue. Scarringor inflammationof the tissue makes the
lungs unable to expand fully (restrictive lung disease). Pulmonary
fibrosis and sarcoidosis are examples of lung tissue disease.
 Lung circulation diseases -- These diseases affect the blood
vessels in the lungs. They are caused by clotting, scarring, or
inflammationof the blood vessel. These diseases may also affect
heart function. An example of a lung circulationdisease is
pulmonary hypertension.
Many lung diseases involve a combination of these three types.

3. Some of the most common lung diseases include:
Asthma
Lung cancer
Lung cancer
The lungs are located in the chest. When you breathe, air goes
through your nose, down your windpipe (trachea), and into the
lungs, where it flows through tubes called bronchi. Most lung cancer
begins in the cells that line these tubes.
There are two main types of lung cancer:
Non-small cell lung cancer is the most common type of lung cancer.

4. Small cell lung cancer (SCLC) makes up about 20% of all lung cancer
cases.
If the lung cancer is made up of both types, it is called mixed small
cell/large cell cancer.If the cancer started somewhere else in the
body and spreads to the lungs, it is called metastatic cancer to the
lung.
Causes:
 Exposure to asbestos and to cancer-causing chemicals such as
uranium, beryllium, vinyl chloride, nickel chromates, coal
products, mustard gas, chloromethyl ethers, gasoline,radongas
and diesel exhaust.
 Family history of lung cancer.
 High levels of arsenic in drinking water and air pollution.
Symptoms:
Early lung cancer may not cause any symptoms.
Symptoms depend on the type of cancer you have, but may include:
 Chest pain
 Coughing up blood
 Fatigue
 Lose of weight
 Wheezing
Other symptoms that may also occur with lung cancer, often in the
late stages:
 Bone pain or tenderness
 Eyelid drooping
 Facial paralysis
 Hoarseness or changing voice

5.  Joint pain
 Weakness
Teststoconformcancer:
Lung cancer can be found from a CTscan or X ray .If lung cancer is
suspected the victim will be asked if he smokes or working under any
cancer causing chemicals.
Tests to see how large the cancer is spread include:
 x-ray, MRI and CT scan of the chest.
 Positron emission tomography (PET) scan.
 Sputum test to look for cancer cells.
 Thoracentesis (sampling of fluid buildup around the lung)
In most cases, Biopsy is done (taking a small piece of lung and
observing it)
 Bronchoscopy combined with biopsy
 Ultra sound directed needle biopsy
 Endoscopic esophageal ultrasound (EUS) with biopsy
 Mediastinoscopy with biopsy
 Pleural biopsy
Treatment:

6. Treatment for lung cancer depends on the type of cancer, how
advanced it is, and how healthy you are:
 Surgery to remove the tumor may be done when it has not spread
beyond nearby lymph nodes.
 Chemotherapy uses drugs to kill cancer cells and stop new cells from
growing.
 Radiation therapy uses powerful x-rays or other forms of radiation to
kill cancer cells.
Prevention:
Cessation of smoking and eliminating exposure to tobacco smoke is
the most important measure that can prevent lung cancer. Many
products, such as nicotine gum, nicotine sprays, or nicotine inhalers,
may be helpful to people trying to quit smoking.
Non Small cell lung cancer(SCLC)
Non-small cell lung cancer is the most common type of lung cancer.
It usually grows and spreads more slowly than small cell lung cancer.
There are three common types of non-small cell lung cancer (NSCLC):
Adenocarcinomas are often found in an outer area of the lung.
Squamous cell carcinomas are usually found in the center of the lung
next to an air tube (bronchus).
Large cell carcinomas can occuIf the biopsy shows cancer, more
imaging tests are done to find out the stage of the cancer. Stage
means how big the tumor is and how far it has spread.
NSCLC is divided into 5 stages:
Stage 0 - spread beyond the inner lining of the lung.

7. Stage I - small and has not spread to the lymph nodes.
Stage II - some lymph nodes near the original tumor are affected.
Stage III - spread to other lymph nodes away.
Stage IV - spread to other organs of the body, such as brain or liver.
There are many different types of treatment for NSCLC. Treatment
depends on the stage of the cancer.
Surgery is the common treatment for NSCLC that has not spread
beyond nearby lymph nodes. The surgeon may remove:
One of the lobes of the lung (lobectomy)
Only a small part of the lung (wedge or segment removal)
The entire lung (pneumonectomy)
Some people need chemotherapy. Chemotherapy uses drugs to kill
cancer cells. It may also be given before surgery or radiation to make
those treatments more effective. This is called neoadjuvant therapy.
It may be given after surgery to kill any remaining cancer. This is
called adjuvant therapy.
Small cell lung cancer (SCLC)
Small cell lung cancer (SCLC) is a fast-growing type of lung cancer. It
spreads much more quickly than non-small cell lung cancer. Most
common in womens.There are two types of SCLC:
Small cell carcinoma (oat cell cancer) and combined small cell
carcinoma.
NOTE :

8. Examining tissue samples from lung cancer patients, the researchers
found that nearly 6% showed signs they may have been driven by a
strain of known to cause cancer.
Cancer cure centers in india:
Tata Memorial Hospital, Mumbai.
Rajiv Gandhi Cancer Institute and Research Centre, Delhi.
Fortis Malar Hospital and Adyar Cancer Institute, Chennai
Asthma
Asthma is a common inflammation of the airways and can be very
distressing. We look at the treatments and preventative measures
for this condition.Asthma is a chronic disease in which sufferers have
repeated attacks of difficulty in breathing.The main airway
(windpipe, trachea) of the body is about 2 to 3cm across. It divides
into its main branches (bronchi), which lead to the right and left lung.
Each bronchus divides further, like the branches of a tree, to supply
air to all parts of the lungs.The smallest tubes (bronchioles) are only
millimetres wide and they are made up of ring-shaped muscles that
are capable of contracting or relaxing.
Anything that makes them contract will narrow the passages, which
makes it more difficult for the air to pass through (so making it
harder to breathe) and also gives rise to the characteristic wheezy
noise that a person makes when they have an asthma
attack.Asthmatics tend to be sensitive to various types of irritants in
the atmosphere that can trigger this contraction response from the
bronchial muscles.The bronchioles also have an inner lining that
becomes inflamed in asthma. This inflammation makes the lining
swell (further narrowing the airway) and produce an excess amount
of the mucus (phlegm) it normally makes, clogging up the tubes.

9. All of these processes contribute to the airway narrowing and the
treatment for asthma is aimed at reversing them as much as
possible. The airway inflammation and narrowing may be an on-
going chronic problem which is intermittently made worse during
acute asthma attacks.
As many different factors come together to cause asthma, there are
many different types of the disease, separated by age and
severity.Adults and children share the same triggers for symptoms
that set off an allergic response in the airways, including airborne
pollutants, mold, mildew, and cigarette smoke.
are chemicals that are released from the lungs in
people with asthma, causing inflammation and increased mucus
production in the airways. They also cause the muscles lining the
airways to contract, which narrows the airways. All of this makes it
difficult for air to get in and out of the lungs.
Typesof asthma
Childhood asthma:
Children are more likely to have an intermittent form of asthma that
presents in severe attacks. Some children might experience daily

10. symptoms, but the common characteristic among children with
asthma is a heightened sensitivity to substances that cause allergy.
Adult-onsetasthma:
Asthma in adults is often persistent and requires the daily
management of flare-ups and preventing symptoms. Asthma can
begin at any age.
Occupationalasthma:
This is a type of asthma that occurs as a direct result of a job or
profession.Symptoms will become apparent after attending a
particular workplace. Industries with regular associations to
occupational asthma include baking, laboratory work, or
manufacturing.
In this type, the work environment leads to the return of childhood
asthma or the start of adult-onset asthma.Other symptoms might
include a runny nose and red eyes.
Difficult-to-controlandsevereasthma:
These types involve consistent, debilitating asthma symptoms and
breathing difficulties. Around 12 percent of people with asthma have
difficult-to-control or severe asthma.With the correct medication
and effective trigger avoidance, those in this category can bring
asthma symptoms back under control.
Newer medications are becoming available to address the different
forms of severe asthma, such as eosinophilic asthma that does not
link to any allergic reactions.
Seasonalasthma:

11. This type occurs in response to allergens that are only in the
surrounding environment at certain times of year, such as cold air in
the winter or pollen during hay fever season.People still have asthma
for the rest of the year but do not experience symptoms.
Symptoms:
Asthma symptoms vary from person to person. You may have
infrequent asthma attacks, have symptoms only at certain times —
such as when exercising — or have symptoms all the time.
Asthma signs and symptoms include:
 Shortness of breath
 Chest tightness or pain
 coughing or wheezing
 A whistling or wheezing sound when exhaling (wheezing is a
common sign of asthma in children)
 Coughing or wheezing attacks that are worsened by a
respiratory virus, such as a cold or the flu
Signs that your asthma is probably worsening include:
 Increasing difficulty breathing (measurable with a peak flow
meter, a device used to check how well your lungs are
working).
 The need to use a quick-relief inhaler more often.
For some people, asthma signs and symptoms flare up in certain
situations:
Exercise-induced asthma, which may be worse when the air is cold
and dry
Occupational asthma, triggered by workplace irritants such as
chemical fumes, gases or dust

12. Allergy-induced asthma, triggered by airborne substances, such as
pollen, mold spores, cockroach waste or particles of skin and dried
saliva shed by pets (pet dander)
Causes:
Many different aspects of a person's environment and genetic
makeup can contribute to the development of asthma.Asthma is the
most common chronic disease among children. The first symptoms
become clear at around 5 years of age in the form of wheezing and
regular infections in the respiratory tracts.
The following are the primary causes of asthma:
Allergies:
A strong link exists between allergies and asthma.
One 2013 study in the Annals of Asthma, Allergy, and Immunology
suggests that over 65 percent of adults with asthma over the age of
55 years also have an allergy, and the figure is closer to 75 percent
for adults between the ages of 20 and 40 years.
Common sources of indoor allergens include animal proteins, mostly
from cat and dog dander, dust mites, cockroaches, and fungi.
Smokingtobacco:
Research has linked tobacco smoke to an increased risk of asthma,
wheezing, respiratory infections, and death from asthma. In addition,
the children of parents who smoke have a higher risk of developing
asthma.Smoking makes the effects of asthma on the airways worse

13. by adding coughing and breathlessness to its symptoms, as well as
increasing the risk of infections from the overproduction of mucus.
Environmentalfactors:
Air pollution both in and out of the home can impact the
development and triggers of asthma.Allergic reactions and asthma
symptoms often occur because of indoor air pollution from mold or
noxious fumes from household cleaners and paints.
Pollen:
Anything from pollen to pollution can trigger an asthma attack and
inflame the airways.
Other asthma triggers in the home and environment include:
 pollution
 sulphur dioxide
 nitrogen oxide
 ozone
 cold temperatures
 high humidity
Heavy air pollution tends to cause a higher recurrence of asthma
symptoms and hospital admissions.
Smoggy conditions release the destructive ingredient known as
ozone, causing coughing, shortness of breath, and even chest pain.

14. These same conditions emit sulfur dioxide, which also results in
asthma attacks by constricting the airways.
Changes in the weather might also stimulate attacks. Cold air can
lead to airway congestion, constricted airway, extra secretions of
mucus, and a reduced ability to clear that mucus.Humidity might also
lead to breathing difficulties for populations in some areas.
Obesity:
Some studies, such as this report from 2014, suggest a link between
obesity and asthma, although the American Academy of Asthma,
Allergies, and Immunology does not recognize obesity as a formal
risk factor for asthma.Obesity can worsen asthma symptoms and
make them more difficult manage. Simply being obese may put you
at increased risk of developing asthma.The inflammatory
mechanisms that drive asthma also link to obesity.
Stress:
People who undergo stress have higher asthma rates. Increases in
asthma-related behaviors during stressful times, such as smoking,
might explain these increased rates.Emotional responses, including
laughter and grief, might trigger asthma attacks.
Genetics:
A parent can pass asthma on to their child. If one parent has asthma,
there is a 25 percent chance that a child will develop asthma. Having
two parents with asthma increase the risk to 50 percent.
Many genes are involved in passing on asthma. These genes can
interact with the environment to become active, although confirming
these findings may require further research.

15. Atopy:
Atopy is a general class of allergic hypersensitivity that leads to
allergic reactions in different parts of the body that do not come in
contact with an allergen. Examples include eczema, hay fever, and an
eye condition called allergic conjunctivitis.During atopy, the body
produces more immunoglobin (IgE) antibodies than usual in
response to common allergens.It leads to production of IgE cells.
The most common type of asthma is atopic asthma, and atopy plays
a key role in its development.
Menstrualcycle:
One type of asthma, known as perimenstrual asthma (PMA), leads to
acute symptoms during the menstrual cycle and a particular
sensitivity to aspirin.
The sex hormones that circulate during menstruation, such as
luteinizing hormone (LH) and follicle-stimulating hormone (FSH),
impact immune activity. This increased immune action can cause
hypersensitivity in the airways.
Diagnosis:
Three main components comprise an accurate asthma diagnosis:
Medical history, observations during a physical exam, and results
from breathing tests.A primary care physician will administer these
tests and determine the level of asthma as mild, intermittent,
moderate, or severe in people who show signs of the condition, as
well as identifying the type.
Keep a note of any potential triggers of asthma symptoms to help
guide treatment, including information about any potential irritants
in the workplace.

16. Be sure to identify any health conditions that can interfere with
asthma management, such as:
 sinus infections
 acid reflux
 psychological stress
 sleep apnea
Young children who develop asthma symptoms before the age of 5
years find it more difficult to receive a clear diagnosis. Doctors might
confuse asthma symptoms with those of other childhood
conditions.If children experience wheezing episodes during colds or
respiratory infections in early life, they are likely to develop asthma
after 6 years of age.
A physical examination will generally focus on the upper respiratory
tract, chest, and skin. A doctor will listen for signs of wheezing, or a
high-pitched whistle on breathing out, in the lungs during a breath
using a stethoscope. Wheezing is a key sign of both an obstructed
airway and asthma.
Physicians will also check for swollen nasal passages, and soft
growths on the inside of the nose and check for skin conditions
including eczema and hives. These are allergic conditions that link to
asthma and suggest heightened immune activity that could be
causing any wheezing.People with asthma do not always show
physical symptoms always.
Testtoconformasthma:
Lung function tests are another component of an asthma diagnosis.
They measure how much air a person inhales and exhales and the
speed with which a person can expel air from the lungs.
A spirometry test can provide an indication of lung function.

17. A spirometry can help assess lung function.
Spirometry is a non-invasive test that requires deep breaths and
forceful exhalation into a hose. The hose links to a machine called a
spirometer that displays two key measurements:
Forced vital capacity (FVC), or the maximum amount of air a person
can inhale and exhale.
Forced expiratory volume (FEV-1), the maximum amount of air a
person can exhale in one second.
The doctor then compares these measurements against what would
be normal for another person of the same age. Measurements below
normal indicate obstructed airways and probable asthma.
A bronchodilator drug to open air passages before retesting with the
spirometer to confirm the diagnosis. If results improve after using
the drug, the risk of an asthma diagnosis increases.
Children under 5 years of age are difficult to test using spirometry, so
asthma diagnoses will rely mostly on symptoms, medical histories,
and other parts of the physical examination process.

18. A bronchoprovocation test, also known as a "challenge test" involves
the administration an airway-constricting substance, such as cold air,
to deliberately trigger airway obstruction and asthma symptoms.
Similarly, a challenge test for exercise-induced asthma would consist
of vigorous exercise with the aim of triggering symptoms. The doctor
then conducts a spirometry, and if measurements are still normal,
they are not likely to reach a diagnosis of asthma.
Doctors may also test for other diseases with similar symptoms,
such as:
 gastroesophageal reflux disease (GERD)
 heartburn
 hay fever
 sinusitis
 chronic obstructive pulmonary disease (COPD)
 airway tumors and obstruction
 bronchitis
 pneumonia
 a blood clot in the lung, or pulmonary embolism
 congestive heart failure
 vocal cord dysfunction
 viral lower respiratory tract infection
These are the common methods to test the level of asthma:
 electrocardiogram (ECG)
 gastroesophageal reflux assessment
Prevention:
 Get vaccinated for influenza and pneumonia. Staying current
with vaccinations can prevent flu and pneumonia from triggering
asthma flare-ups.

19.  Identify and avoid asthma triggers and treat early.
 Take your medication as prescribed.
 Pay attention to increasing quick-relief inhaler use.