Lung disease kills 4 million people every year. It kills more people than any other disease worldwide. Lung disease is a broad term that encompasses multiple conditions that prevent your lungs from working properly. October is Healthy Lung Month. Let’s use this time to learn more about our lungs and some of the disorders that threaten their health.

Your lungs are a pair of air-filled organs located in your chest. Each lung is made up of smaller sections called lobes. Your right lung has three lobes and your left lung has two lobes. The lungs are part of your respiratory system, a group of organs and tissues responsible for bringing fresh air into your body and expelling waste gases, mainly carbon dioxide, out of your body.

There are many conditions that can affect your lungs, but they are typically divided into three main categories: airway diseases, lung tissue diseases and lung circulation diseases. Each group of diseases impacts the lungs in a different way.

Airway diseases primarily affect the tubes, or airways, that carry oxygen and waste gases into and out of the lungs. Asthma and chronic obstructive pulmonary disease, or COPD, are examples of airway diseases of the lungs.

With asthma, your airways become inflamed and swell, and often produce excess mucus, making it difficult to breath. The most common conditions associated with COPD are chronic bronchitis and emphysema. Chronic bronchitis is inflammation of the bronchial tubes, the airways that carry air to and from the air sacs, or alveoli, in the lungs. Emphysema involves the destruction of the alveoli. Smoking is the most common cause of COPD.

Lung tissue diseases affect the structure of the lung tissue. With these diseases, the lungs are unable to fully expand as you breathe due to inflammation and scarring. This makes it difficult for your lungs to take in oxygen and remove carbon dioxide. Pulmonary fibrosis and sarcoidosis are examples of lung tissue diseases.

Pulmonary fibrosis is a condition in which the lung tissue becomes scarred, thickened and stiff. The scar tissue makes it difficult for the lungs to open up and take in air. With sarcoidosis, your immune system cells clump together and form granulomas, or small areas of inflammation. This can occur in any organ of your body, but it most commonly affects the lungs.

Lung circulation diseases impact the blood vessels in the lungs. They most often involve clotting, scarring or inflammation of the blood vessels. Pulmonary hypertension is a common lung circulation disease. Pulmonary hypertension develops when the pressure in the arteries leading from the heart to the lungs increases. If the pressure becomes too high, the arteries in the lungs can become narrow, restricting blood flow to the lungs.

Lung cancer is another common disease that affects the airways and tissues of the lungs.

Lung cancer is the leading cause of death in the US. It makes up almost 25 percent of all cancer deaths. It is the second most commonly diagnosed cancer in both men and women in the US, excluding skin cancer. In men, prostate cancer is more common, and in women, breast cancer is more common. People who smoke are at the highest risk for developing lung cancer.

Each lung disease has its own set of signs and symptoms, but there are some symptoms that are common to several disorders. These include: shortness of breath with activity; chronic cough; chest tightness; wheezing; rapid, shallow breathing; hoarseness; recurring respiratory infections and fatigue. In rare cases, lung cancer can grow into the nearby blood vessels and cause severe bleeding.

To determine if you have a lung disease, your doctor will perform a physical exam during which he or she will listen to your lungs and breathing. The doctor will review your personal and family history, including your smoking status, risk factors and the severity of your symptoms. Your doctor may use certain tests and procedures to help in making the diagnosis.

Tests and procedures your doctor may employ include: chest x-ray, CT scan, pulmonary functions tests, pulse oximetry, arterial blood gas, bronchoscopy and lung cancer screening.

Treatment depends on the type of lung disease, but it may include medications such as inhaled corticosteroids, which reduce swelling and inflammation of lung tissue, and oral or intravenous medications. Treatment for lung cancer may include surgery, chemotherapy, radiation therapy, targeted drug therapy and immunotherapy.

There are some steps you can take to reduce your risk for lung disease and keep your lungs healthy:

• Don’t smoke – Smoking cause chronic inflammation in the lungs, destroys lung tissue and may trigger changes that develop into lung cancer.
• Avoid exposure to indoor pollutants – Secondhand smoke, chemicals in the home and workplace and radon can cause or worsen lung disease.
• Minimize exposure to outdoor pollutants – Avoid being outdoors for long periods when pollution is high and air quality is poor.
• Prevent infection – Wash your hands often and avoid crowds during cold and flue season. Get vaccinated against the flu and ask your doctor if the pneumonia vaccine is right for you.
• Exercise – Regular physical activity can help keep your lungs – and heart – healthy.

Your lungs are a pair of spongy, pyramid-shaped organs in your chest that bring fresh oxygen into your body when you inhale. The lungs also send out carbon dioxide, a waste product of cellular function, when you exhale. The lungs, along with a network of air passages, are part of your body’s respiratory system.

Lung cancer is a type of cancer that starts in the lungs. Cancer is a disease that occurs when cells grow and divide uncontrollably and destroy body tissue. Lung cancers can begin in any part of the lungs, but 90 to 95 percent of cancers of the lung arise from the epithelial cells. Those are the cells that line the larger and smaller air passages, called bronchi and bronchioles.

Lung cancer is the number one cause of cancer deaths in both men and women in the United States and worldwide. It’s estimated that in 2020, 228,820 adults in the US will be diagnosed with lung cancer, and 135,720 Americans are expected to die from it. But there is some good news. Death rates have declined by 51 percent since 1990 in men and 26 percent in women since 2002.

Research suggests that these declines are the result of more people not smoking and more people quitting smoking, as well as to advances in lung cancer diagnosis and treatment.

Lung cancers are generally grouped into two main categories: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). These cancers are distinguished by the way their cells look under a microscope, particularly the size of their cells. SCLC and NSCLC grow and spread differently and are often treated differently.

NSCLC is the most common type of lung cancer, accounting for 84 percent of all lung cancer diagnoses. NSCLC is an umbrella term for several subtypes of lung cancer: Adenocarcinomas start in the mucus-secreting cells of the lungs, squamous cell carcinomas generally arise in the central chest area in the bronchi, and large cell carcinomas, the least common, start in the lungs’ outer edges.

SCLC, which accounts for 10 percent to 15 percent of all lung cancer cases, is the most aggressive lung cancer. It spreads rapidly to other areas of the body and is most often discovered after it has spread extensively. In fact, about 70 percent of people with SCLC will have disease that has already spread at the time they are diagnosed.

Other cancers can occur in the lungs as well. Bronchial carcinoids, which account for up to 5 percent of lung cancers, are typically small when diagnosed and most often occur in people under 40 years old. Other types of lung cancer, including adenoid cystic carcinomas, lymphomas and sarcomas, as well as benign lung tumors such as hamartomas, are rare.

There are certain factors that put you at higher risk for developing lung cancer. The number one risk factor for lung cancer is smoking. Lung cancer is strongly associated with cigarette smoking, with about 90 percent of lung cancers arising because of tobacco use. Exposure to secondhand smoke also increases your risk for developing lung cancer.

Another lung cancer risk factor is exposure to radon, a naturally occurring gas that results from the breakdown of uranium in soil and rocks that can accumulate in your home. Other risk factors include exposure to asbestos, diesel exhaust and other cancer-causing agents in the workplace; air pollution; previous radiation therapy and a personal or family history of lung cancer.

In many cases, there are no symptoms in the early stages of lung cancer. It is often discovered on a routine imaging exam for another condition. But in some cases, symptoms are present. If you notice any signs and symptoms of lung cancer, visit your doctor right away. Your doctor may be able to diagnose lung cancer at an early stage, when treatment is more likely to be effective.

Signs and symptoms of lung cancer include: a cough that doesn’t go away or gets worse; coughing up blood or rust-colored sputum; chest pain that’s worse with deep breathing, coughing or laughing, shortness of breath; hoarseness; loss of appetite, unexplained weight loss; fatigue; a respiratory infection that won’t go away; and new onset of wheezing.

Diagnosing lung cancer begins with a thorough medical history and physical exam followed by a combination of diagnostic tests and procedures. Tests used may include x-ray, CT, MRI; PET, bone scan, blood tests and sputum cytology. Your doctor may also perform a bronchoscopy, thoracentesis and/or needle biopsy to obtain tissue samples for examination under a microscope to look for cancer cells.

The treatment you receive will depend on several factors, including the type of lung cancer you have, how far it has spread, called the stage, and your overall health. You may get more than one type of treatment.

Treatments for SCLC include surgery, chemotherapy, radiation therapy, immunotherapy and laser therapy, which uses a laser to kill cancer cells. Treatments for NSCLC include surgery, radiation therapy, chemotherapy, immunotherapy, laser therapy and targeted therapy, which uses specific medications to target and kill cancer cells while avoiding harming healthy cells.

There’s no sure way to prevent lung cancer, but there are steps you can take to reduce your risk for developing it. Don’t smoke, but if you do, quit, and avoid secondhand smoke; test your home for radon and make any necessary upgrades; avoid asbestos, diesel exhaust and other cancer-causing agents at work; and maintain a healthy lifestyle. Eat a diet rich in fruits and vegetables and exercise regularly.

 

In 2008, I lost my father to lung cancer. The diagnosis came just three short months before his death at age 80. He was a lifetime smoker, having picked up the bad habit at the young age of 17. The dangers of cigarette smoking were years away from being unveiled and back in the 1940s, smoking was “socially acceptable.”

But in 2006, the world was shocked by the passing of Dana Reeve, widow of actor Christopher Reeve. Never having smoked a day in her life, Ms. Reeve died of lung cancer because of her exposure to second hand smoke while working for years as a singer in bars and restaurants filled with smoke.

Physicians and researchers believe that passive smoke — the smoke exhaled by others — is potentially even more dangerous than actively inhaled smoke.

Just last week, I was taken back by the sudden passing of a friend’s wife from lung cancer. She was 45 and leaves behind two young sons.

Another variable is genes. It is clear that some families have a higher occurrence of lung cancer than would be expected. While some of this might be due to shared smoking, some evidence suggests there are certain genes that predispose to lung cancer.

In approximately 40 percent of people diagnosed with lung cancer, the diagnosis is made after the disease has advanced. In one third of those diagnosed, the cancer has reached stage 3.

According to the Mayo Clinic, signs and symptoms of lung cancer may include:

• A new cough that doesn’t go away
• Changes in a chronic cough or “smoker’s cough”
• Coughing up blood, even a small amount
• Shortness of breath
• Chest pain
• Wheezing
• Hoarseness
• Losing weight without trying

So, as a smoker, be courteous and careful to those around you. And as a non-smoker, be aware of the risk of being around smoke, even if you don’t smoke yourself!