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The Lungs

Asthma

What is asthma?

Asthma is an inflammatory lung disease that can lead to mild to severe symptoms. In most cases, you can control asthma through avoiding triggers, daily medications and other treatment options.

If you continue to have symptoms, you may needed additional medications such corticosteroids.

For those with severe asthma, the highest dose of standard medications may not alleviate frequent and life-threatening asthma attacks. Few treatment options are available to adequately control the disease which can have a significant impact on quality of life.

Treatment For Severe Asthma

Bronchial Thermoplasty

Non-drug Treatment for Severe Asthma

Bronchial Thermoplasty (BT) is a procedure to reduce the smooth muscle mass of the airway. With less smooth muscle, the airways constrict less, reducing severe asthma attacks.

Bronchial Thermoplasty (BT) is the first non-drug treatment option for patients with severe asthma who are 18 years and older and whose asthma is not well controlled by inhaled corticosteroids and long-acting beta-agonists. This minimally invasive outpatient procedure supplements conventional asthma drug treatments for better management of the disease.

It’s a heat treatment that reduces the amount of thickened smooth muscle on the inside walls of the airways. Over time, severe asthma causes the smooth muscle tissue lining the airways to thicken. This means the airways are narrower and it’s harder to breathe.

Emphysema

What is Emphysema?

Emphysema is a type of chronic obstructive pulmonary disease (COPD). In this condition, the air sacs in the lungs become damaged and stretched. This damage is permanent and irreversible, this results in a chronic cough and difficulty breathing.

Smoking is the number one factor. Because of this, emphysema is one of the most preventable types of respiratory diseases.

Cigarette smoking not only destroys lung tissue, it also irritates the airways. This causes inflammation and damage to cilia that line the bronchial tubes. This results in swollen airways, mucus production, and difficulty clearing the airways. All of these changes can lead to shortness of breath.

Treatment For Emphysema

Bronchoscopic lung volume reduction (BLVR)

Most people with emphysema also have chronic bronchitis. Chronic bronchitis is inflammation of the tubes that carry air to your lungs (bronchial tubes), which leads to a persistent cough.

BLVR, is a minimally invasive procedure that involves no incisions or stitches, to relieve lung hyperinflation. BLVR can help people with severe emphysema that doesn’t improve with other standard treatments, such as medications, pulmonary rehabilitation, and oxygen treatment.

In BLVR, our doctor will place tiny, one-way valves in the airways in the hyperinflated emphysematous sections of the lungs. The valves prevent air from entering the diseased areas but allow trapped air and secretions to escape.

Lung Cancer

Lung cancer is a type of cancer that originates from the lungs. There are two main types of lung cancer; 80-85% of the cases are non-small cell lung cancer (NSCLC) and 10-15% are small cell lung cancer (SCLC).

The subtypes under NSCLC originate from larger cells and are generally less aggressive. SCLC subtypes appear small and round under a microscope and tends to spread faster than NSCLC.

What are the risk factor of lung cancer?

There are certain risk factors that can increase a person’s chance of getting lung cancer, such as:

  • Tobacco smoke
  • Second-hand smoke
  • Exposure to radon
  • Exposure asbestos
  • Air pollution
  • Family history of lung cancer

What are the lung cancer sign & symptoms?

There are usually no signs during early-stage lung cancer. Symptoms of lung cancer develops as the cancer progresses. If you have these symptoms, it’s important to see a doctor immediately:

  • A cough that does not go away or gets worse
  • Coughing up blood or rust coloured phlegm
  • Chest pain
  • Loss of appetite
  • Unexplained weight loss

Diagnosis of Lung Cancer

Lung cancer, including early lung cancer, can be detected by a low dose CT scan with minimal radiation. This is helpful for those with risk factors for lung cancer e.g. smokers.

A CT scan will pick up a growth in the lung. If this is seen, tissue biopsy can be arranged. A bronchoscopy, which is an endoscopic examination of the airways, can also be done which will identify more central tumours.

This investigation is often done in those who cough up blood. Additional tests may be required to stage i.e. determine how advanced the cancer is. These tests include endobronchial ultrasound and biopsy, mediastinoscopy and biopsy, anterior mediastinotomy and biopsy, and VATS biopsy.

Treatment For Lung Cancer

The best outcome for lung cancer is to remove it surgically. In the early stages of lung cancer, this is all that may be needed. If the lung cancer is larger or involves the lymph nodes, additional treatment with immunotherapy or chemotherapy may also be needed in addition to surgery.

If the lung cancer is very advanced and has spread to other organs elsewhere, treatment is usually only with immunotherapy and chemotherapy with our without radiotherapy. Examples of lung resection surgery are lobectomy, pneumonectomy, segmentectomy, and wedge resections.

Lobectomy
Your right lung is divided into three parts called lobes, and the left lung into two parts. Lobectomy is the removal of one of the lobes of the lung that is affected by lung cancer.

Pneumonectomy
This procedure is the removal of the entire lung affected by cancer. The procedure is usually done if the cancer cannot be fully removed by lobectomy or the lesion is centrally located.

Pneumothorax

A pneumothorax is the medical term for a collapsed lung. This occurs when air leaks into the space between your lungs and chest wall, causing your lung to collapse.

A pneumothorax could cause a partial lung collapse or a complete lung collapse.

What are the causes of pneumothorax?

A pneumothorax can be traumatic or non-traumatic. Traumatic pneumothorax occurs when there is an injury that damage the chest, leading to an air leak, caused by:

  • Motor vehicle accidents
  • Broken ribs
  • Stab wounds
  • Medical procedures such as lung biopsies or CPR

Non-traumatic pneumothorax can be caused by:

  • Smoking
  • Lung bullae (cysts)
  • Emphysema
  • Previous pneumothorax

What are the pneumothorax sign & symptoms?

Severity of symptoms may vary depending on the portion of lung that is collapsed. Some pneumothorax can be life threatening, so see a doctor if you experience:

  • Sudden chest pain
  • Shortness of breath
  • Tightness in the chest
  • Turning blue
  • Fast heart rate

Treatment For Pneumothorax

Treatment will depend on severity, past experience and symptoms experienced. The main goal of pneumothorax treatments is to relieve pressure on the lungs allowing it to re-expand.

Mild cases of pneumothorax do not require treatment and can be observed with chest X-rays. In more severe cases, the air in the chest cavity can be aspirated or a chest drain inserted.

If the pneumothorax persists, or if it recurs, then key hole surgery is advised. This is performed through small incisions, a procedure called Video Assisted Thoracoscopic (VATS) surgery. The part of the lung which is leaking air is excised and inflammation is triggered between the lung and the chest wall so that the lung will stick to the chest wall and not collapse again even if air should leak again.

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