Lung disease refers to disorders that affect the lungs, the organs that allow us to breathe. Breathing problems caused by lung disease may prevent the body from getting enough oxygen. Examples of lung diseases are:
What are the most common types of lung disease?
Asthma is a temporary narrowing of the airways (bronchi) that causes sudden shortness of breath, wheezing and a tight feeling in the chest.
Bronchitis is a condition where the bronchi are inflamed and an excessive amount of mucus is produced, causing increased coughing.
The bronchi may also become narrower, making it harder for air to get in and out of the lungs and leading to breathlessness.
Cancer is a disease of the cells that make up the organs and tissue of the body. Some common symptoms of lung cancer are a persistent cough, a chest infection that does not get better and shortness of breath.
A chest X-ray may show abnormalities in the lung and pleura (lining of the lung and chest wall) but a doctor may request further tests to make a diagnosis of lung cancer.
Emphysema is caused by an over-stretching of the alveoli in the lungs and results in the lungs not working as well as they should. Cigarette smoking is the most common cause of emphysema. However, industrial pollutants can also be responsible.
Fibrosing alveolitis occurs when the alveoli become inflamed and scarred. The condition leads to shortness of breath.
Treatment is usually a combination of steroids and immunosuppressants (medication which suppresses the body’s defence mechanism) and physiotherapy.
Sarcoidosis is a condition that most commonly affects the lungs, skin and eyes. It can cause breathlessness, a dry cough in the lungs, or fever and joint pains throughout the body.
Symptoms often clear up after a few weeks and treatment is usually with steroids. Only a small proportion of people will need long-term treatment.
What causes lung disease?
Experts don’t know the causes of all types of lung disease, but they do know the causes of some. These include:
Smoking. Smoke from cigarettes, cigars, and pipes is the number one cause of lung disease. Don’t start smoking, or quit if you already smoke. If you live or work with a smoker, avoid secondhand smoke.
Ask smokers to smoke outdoors. Secondhand smoke is especially bad for babies and young children.
Radon. This colorless, odorless gas is present in many homes and is a recognized cause of lung cancer. You can check for radon with a kit bought at many hardware stores. Radon can be reduced in your home if you find out there are high levels.
Asbestos. This is natural mineral fiber that is used in insulation, fireproofing materials, car brakes, and other products.
Asbestos can give off small fibers that are too small to be seen and can be inhaled. Asbestos harms lung cells, causing lung scarring and lung cancer.
It can cause mesothelioma (MEZ-oh-THEE-lee-OH-muh), which is a cancer that forms in the tissue covering the lungs and many other organs of the body.
Air pollution. Recent studies suggest that some air pollutants like car exhaust may contribute to asthma, COPD, lung cancer, and other lung diseases.
Some diseases that affect the lungs, like the flu, are caused by germs (bacteria, viruses, and fungi).
How would I know if I have a lung disease?
Early signs of lung disease are easy to overlook. Often, an early sign of lung disease is not having your usual level of energy.
The signs and symptoms can differ by the type of lung disease. Common signs are:
- Trouble breathing
- Shortness of breath
- Feeling like you’re not getting enough air
- Decreased ability to exercise
- A cough that won’t go away
- Coughing up blood or mucus
- Pain or discomfort when breathing in or out
Make sure to call your doctor if you have any of these symptoms.
How can I find out if I have asthma?
Asthma can be hard to diagnose. The signs of asthma can seem like the signs of COPD, pneumonia, bronchitis, pulmonary embolism, anxiety, and heart disease.
Common symptoms of asthma are:
- Chest tightness
- Shortness of breath
To diagnose asthma, the doctor asks about your symptoms and what seems to trigger them, reviews your health history, and does a physical exam.
To confirm the diagnosis, the doctor may do other tests, such as:
Spirometry (speye-ROM-eh-tree). The doctor uses a medical machine called a spirometer. This test measures how much air you can breathe in and out.
It also measures how fast you can blow air out. The doctor may also give you medicines and then retest you to see if your results improve.
Bronchoprovocation (bron-KOH-prah-vuh-KAY-shun). Your lung function is tested using spirometry while more stress is put on the lungs. This may be during physical activity or after you breathe in increasing doses of a special chemical or cold air.
Chest x-ray or EKG (electrocardiogram). These tests can sometimes find out if another disease or a foreign object may be causing your symptoms.
Other tests. The doctor may want to test for other problems that might be causing the symptoms. These include stomach acid backing up into the throat, vocal cord problems, or sleep apnea.
Asthma is a chronic disease. Medicines can be used to treat asthma, but they cannot cure it. You can help control your symptoms by working with your doctor to set up and then follow a personal asthma action plan.
The plan will include possible medications and ways to avoid things that trigger your asthma.
Following an asthma action plan
Your asthma action plan will show:
- The kinds of medicines you should take
- When to take your medicines
- How to regularly monitor your asthma
- Ways to avoid what triggers your asthma
- When to call your doctor or go to the emergency room
Asthma medicines work by opening the lung airways. The medicines used to treat asthma fall into two groups: long-term control and quick relief.
Long-term control medicines are to be taken every day, usually over a long period of time. They help prevent symptoms from starting. Once symptoms occur, they do not give quick relief. These medicines include:
Inhaled corticosteroids. These are the preferred medicines for long-term asthma control. They relieve airway inflammation and swelling.
Long-acting beta2-agonists. These inhaled medicines are often added to low-dose inhaled corticosteroids to improve long-term asthma control.
Leukotriene modifiers. These pills help block the chain reaction that causes inflammation in the airways.
Cromolyn and nedocromil. These inhaled medicines can help keep airways from reacting in response to an asthma trigger.
Theophylline. This is a pill that helps open the airways.
Quick-relief medicines are used only when needed. These include short-acting inhaled beta2-agonists and short-acting bronchodilators, like albuterol and pirbuteral.
Quick-relief medicines often relieve symptoms in minutes. They do this by quickly relaxing tightened muscles around the airways.
They are taken when symptoms worsen to prevent a full-blown asthma attack and to stop attacks once they have started.
Avoiding asthma triggers
Avoid things that make your asthma worse. Common asthma triggers are tobacco smoke, animal dander, dust mites, air pollution, mold, and pollens.
You can try “fragrance-free” products if your asthma is triggered by fragrances. Talk to your doctor about allergy shots if your asthma symptoms are linked to allergens that you cannot avoid. The shots may lessen or prevent the symptoms but will not cure the asthma.
You can reduce your exposure to air pollution by limiting your outdoor activities on days when the air quality in your neighborhood is poor.
What about pregnancy and asthma?
If you have asthma and may become pregnant, talk to your doctor. Only in very severe cases might asthma be a reason to avoid becoming pregnant.
If you have asthma and become pregnant, you and your doctor can discuss the safety of your medicines. Changes in the medicines can sometimes make good sense.
It is very important to manage your asthma symptoms when you are pregnant. Asthma that gets out of control can harm your baby.
You should also talk with your doctor about getting a flu shot. Flu can be very serious for anyone with asthma, but it’s even more of a concern for pregnant women with asthma.
How do I find out if I have chronic obstructive pulmonary disease (COPD)?
People with COPD have symptoms that develop very slowly over many years. As a result, many people ignore these symptoms until their disease has reached an advanced stage. COPD can be easily diagnosed and can be managed.
The symptoms of COPD include:
- An ongoing cough that often produces large amounts of mucus
- Shortness of breath, especially during physical activity
- Chest tightness
If you have some or all of these symptoms, make sure to talk to your doctor.
To find out if you have COPD, the doctor will:
- Ask about your symptoms
- Ask about your medical history, including family history
- Ask about your history of exposure to things that can cause COPD, such as tobacco smoke, air pollution, or chemicals
Do a physical exam, including using a stethoscope to listen for wheezing or other abnormal chest sounds
The main test to check for COPD is spirometry.
For this test, you will be asked to take a deep breath and blow as hard as you can into a tube that is connected to a spirometer. This machine measures how much air you breathe out and how fast.
Other tests can include:
Chest x-ray or chest computed tomography (CT) scan. These tests create pictures of the heart and lungs. The pictures can show signs of COPD. They can also show whether your symptoms are caused by another condition, such as heart failure.
Arterial blood gas test. This blood test measures the oxygen and carbon dioxide levels in your blood. It can help determine how severe the COPD is and whether oxygen therapy is needed.
Treatment for COPD
Damage to the lungs cannot be repaired. The disease can be slowed by avoiding certain exposures, though. For smokers, the best approach is to stop smoking.
You should also limit your exposure to smoke, dust, fumes, and irritating vapors at home and work.
Also limit outdoor activities during air pollution alerts. Treatment can relieve symptoms. Common medicines are:
- Bronchodilators to open up air passages in the lungs
- Inhaled steroids to relieve symptoms by reducing inflammation in the lungs
- Antibiotics to clear up infections in the lungs
For patients with COPD, doctors may also recommend:
Flu shots. Influenza (flu) can cause serious problems for people with COPD.
- Pneumonia shots. The pneumococcal (NOO-muh-kok-uhl) vaccine reduces the risk of some kinds of pneumonia.
- Pulmonary rehabilitation. This treatment helps people cope physically and mentally with COPD. It can include exercise, training to manage the disease, diet advice, and counseling.
- Oxygen therapy. The patient receives extra oxygen, either through a tube or mask.
- Surgery. Sometimes surgery can help people with severe COPD feel better. Lung transplant surgery is becoming more common for people with severe emphysema.
Another procedure called lung volume reduction surgery is also used to treat some patients with severe COPD of the emphysema type. In this surgery, the most damaged part of each lung is removed.
How do I find out if I have lung cancer?
Usually there are no warning signs of early lung cancer. By the time most people with lung cancer have symptoms, the cancer has become more serious.
Symptoms of lung cancer may include:
- A cough that doesn’t go away or gets worse
- Breathing trouble, like shortness of breath
- Coughing up blood
- Chest pain
- Hoarseness or wheezing
- Pneumonia that doesn’t go away or that goes away and comes back
In addition, you may feel very tired, have a loss of appetite, or unexplained weight loss. If you have symptoms of lung cancer, it’s important to talk to your doctor.
The doctor will ask about your health history, smoking history, and exposure to harmful substances. He or she will also do a physical exam and may suggest some tests.
Common tests for diagnosis of lung cancer include:
Chest x-rays. Chest x-rays allow doctors to “see” abnormal growths in the lungs.
Computerized tomography scans (CT scans). CT scans are more powerful than standard x-rays. The images can show subtle signs of cancer that don’t show up on x-rays. This can increase the chances of finding the cancer before it spreads further.
Sputum cytology. A sample of mucus that you cough up is studied to see if it has cancer cells in it.
Bronchoscopy. Doctors pass a special tube called a bronchoscope through the nose or mouth and down into the lungs. They can see into the lungs and remove small bits of tissue to test.
Fine-needle aspiration. Doctors pass a needle through the chest wall into the lung to remove a small amount of tissue or fluid.
Thoracotomy (thohr-uh-KOT-oh-mee). Doctors cut open the chest and remove tissue from the lungs.
If I smoke, should I get tested for lung cancer?
Testing for cancer before a person has any symptoms is called screening. Screening may help find cancers early, when they may be easier to treat.
Many studies show that screening smokers with x-rays or sputum cytology does not save lives. But recently a major study showed that CT scans of older people who smoke a lot (or used to smoke a lot) can save lives.
You can learn more about the results of the study, which is called the National Lung Screening Trial. Experts are still working to figure out who should get CT screening. There are risks and benefits to screening for lung cancer.
For now, the U.S. Preventive Services Task Force (USPSTF) makes no recommendation either for or against routine screening for lung cancer.
If you’re concerned about your lung cancer risk, talk to your doctor about whether screening is right for you. Of course, the best way to reduce your risk of lung cancer is not to smoke.
How is lung cancer treated?
Sometimes lung cancer treatments are used to try to cure the cancer. Other times, treatments are used to stop the cancer from spreading and to relieve symptoms.
Your specific treatment will depend on:
- The type of lung cancer
- Where the cancer is and if it has spread to other parts of the body
- Your age and overall health
Your doctor may recommend one treatment or a combination of treatments.
Surgery is used to remove the lung tissue that has the cancerous tumor. Sometimes a large part of a lung or all of it is removed. When the cancer has not spread, surgery can cure the patient.
Radiation therapy uses a machine to aim high-energy x-rays at the tumor. This energy kills cancer cells. Radiation therapy can relieve pain and make a person feel better.
Chemotherapy uses medicine to kill cancer cells. Chemotherapy medicines can be given through a vein or taken as a pill.
Targeted therapy uses medicine to block the growth and spread of cancer cells. It can be given through a vein or taken as a pill.
To find out about research studies on new treatments for lung cancer, visit clinical trials website of the National Cancer Institute.
Can I lower my risk for lung disease?
Things you can do to reduce your risk of lung diseases include:
Stop smoking. If you smoke, the most important thing you can do is stop. Talk to your doctor about the best way to quit. All kinds of smoking (cigarettes, cigars, pipes, and marijuana) can boost the chances of lung disease.
Avoid secondhand smoke. If you live or work with people who smoke cigarettes, pipes, or cigars, ask them to smoke outside. Non-smokers have the right to a smoke-free workplace.
Test for radon. Find out if there are high levels of the gas radon in your home or workplace. You can buy a radon test kit at most hardware stores.
The U.S. Environmental Protection Agency offers information on how to deal with radon.
Avoid asbestos. Exposure to asbestos can cause scarring of the lungs, lung cancer, and other serious lung disease. Asbestos can be a particular concern for those whose jobs put them in contact with it.
This includes people who maintain buildings that have insulation or other materials that contain asbestos and people who repair car brakes or clutches.
Employers of those who work with asbestos should offer training about asbestos safety and should regularly check levels of exposure. They also should provide ways to limit exposure, such as special breathing masks that filter asbestos dust from the air.
Protect yourself from dust and chemical fumes. Working in dusty conditions and with chemicals can increase your risk of lung disease.
And the risk is not just from industrial chemicals. Many products used at home, like paints and solvents, can cause or aggravate lung disease. Read labels and carefully follow instructions for use.
If possible, avoid using products that cause eye, nose, or throat irritation. If you can’t avoid them, use them as little as possible and only in a well-ventilated area.
Wear protective equipment such as a special mask. Make sure you know which type of equipment you need and how to wear it.
Eat a healthy diet. The National Cancer Institute notes that studies show that eating a lot of fruits or vegetables may help lower the risk of lung cancer. Of course, diet can’t undo the damage caused by unhealthy behaviors like smoking.
Ask your doctor if you should have a spirometry test. Some groups recommend routine spirometry testing of at-risk people, such as people who are over 45 and smoke and those who are exposed to lung-damaging substances at work.
Ask your doctor about protecting yourself from flu and pneumonia with vaccinations.
See your doctor if you have a cough that won’t go away, trouble breathing, pain or discomfort in your chest, or any of the other symptoms described here.