Research Design And Methods
The Kaiser Permanente Medical Care Program in northern California is a large group-practice prepaid health plan that provides comprehensive medical services to a 14-county region. Approximately 30% of the population that resides in the area served by the KPNC are members. From the results of the 1990 and 2000 censuses, we know that the KPNC membership is representative of the population living in the 14-county geographical area with regard to demographic characteristics, race or ethnicity, and socioeconomic status, except that the very poor and the very wealthy are underrepresented .
Exploring The Possible Connections
Researchers believe that one possible explanation for the link between these two conditions is that the inflammation that commonly occurs with asthma could lead to the development of the cancer in some people. While this theory is worth taking note, however, critics point out that although asthma and COPD can cause lung scarring, the scarring won’t cause lung cancer. This raises questions that still remain unanswered.
Additionally, these researchers didn’t look at smoking as a risk factor in this group, although smoking is strongly linked to lung cancer. Therefore, it’s difficult to find meaningful results.
What Is Copd And What Causes It
COPD is a progressive disease that causes airflow obstruction, making it more difficult for a person to breathe. COPD can take the form of chronic bronchitis or emphysema. Chronic bronchitis is the inflammation and scarring of the lungs bronchial tubes, or air passages, which results in frequent coughing and the formation of thick mucus in the airways. In emphysema, the walls of the tiny air sacs in the lungs are damaged and destroyed over time which leads to reduced gas exchange in the lungs. Most people with COPD have a combination of both chronic bronchitis and emphysema.
COPD cant be cured but its symptoms can be managed and controlled through various treatments, including medicines and pulmonary rehabilitation. Pulmonary rehabilitation includes exercise training, counseling, breathing strategies, and energy conservation techniques.
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Superior Vena Cava Syndrome
Tumors in your upper right lung may put pressure on your superior vena cava, a large vein that carries blood from your head and arms to your heart. The pressure may cause blood to back up in your veins.
The symptoms of superior vena cava syndrome may include:
- swelling in your face, neck, arms, and upper chest, sometimes making your skin turn bluish-red
- dizziness or loss of consciousness
Its very important to talk with a doctor right away if you have any of these symptoms, since superior vena cava syndrome can be life threatening.
Measures For Indoor Air Pollution
As many people spend most of their time indoors, to reduce the production of indoor pollutants and avoid inhalation are more important. To choose furniture with less chemical emission, check the ventilation system of the house regularly, ventilate the room as opening the door and windows regularly to fresh the air so as to reduce harmful gaseous pollutants from the furniture and construction material, use clean fuels instead of biomass fuels if possible, improve cooking stoves to burn fuel more efficiently and use a chimney woodstove to vent emissions to outside, and similar interventions are feasible and recommended . These measures can significantly reduced indoor air pollution and relieve symptoms consistent with chronic respiratory tract irritation .
During smoke episodes like forest fires, community members should remain indoors and use air cleaners. The air cleaner can effectively reduce PM2.5 exposure during forest fires and residential wood burning . Electrostatic air cleaners can reduce all size particles. The irritation and general symptom indices decreased . In peoples exposed to smoke from wildfire, using of high-efficiency particulate air cleaners could reduce odds of reporting adverse health effects of the lower respiratory tract .
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Personal Or Family History Of Lung Cancer
If you are a lung cancer survivor, there is a risk that you may develop another lung cancer, especially if you smoke. Your risk of lung cancer may be higher if your parents, brothers or sisters, or children have had lung cancer. This could be true because they also smoke, or they live or work in the same place where they are exposed to radon and other substances that can cause lung cancer.
How Asthma May Cause Lung Cancer
One theory is that long-terminflammation in the lungs due to asthma could be the underlying cause of lung cancer. Long-term inflammation has been evaluated recently as a cause of many cancers. Several studies suggest that chronic inflammation in the lungs due to asthma may be a “cofactor” in causing lung cancermeaning that asthma, combined with other causes, may work together to contribute to lung cancer risk. One of these “other” factors may include a genetic predisposition , and we are learning that genetics appears to play an important role in lung cancer in never smokers.
We are learning that cancer is not just an errant clone of cells that grows alone. Rather, cancer cells interact very closely with nearby tissues, and area that has been coined the “tumor microenvironment.”
In asthma, a type of connective tissue cells known as bronchial fibroblasts are important. In the lab, researchers look at lung cancer cells and signals secreted by human bronchial fibroblasts from both people with and without asthma. The lung cancer cells exposed to signals from fibroblasts from people with asthma were more motile. It’s not certain whether this study could translate to what happens in the human body, and if so, if it would only affect lung cancer cells already present, but the study does illustrate how evaluation of the underlying biological processes in place might better help explain any connection between asthma and lung cancer in the future.
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Types Of Severe Asthma
There are two main categories of severe asthma Type-2 inflammation and Non-Type-2 inflammation. These categories are based on a persons response to treatment. Type-2 inflammation includes allergic asthma and eosinophilic asthma and Non-Type-2 inflammation includes non-eosinophilic asthma. For example, allergic asthma and e-asthma respond to treatment with inhaled corticosteroids and IgE -directed therapy or other biologics listed in the above table. Patients with Non-Type-2 inflammation, including non-eosinophilic asthma, generally do not respond well to inhaled corticosteroids. Allergic asthma and e-asthma have distinct biomarkers and treatment options available today. Treatments for non-eosinophilic asthma are currently being development.
Allergic asthma is caused by exposure to allergens such as pollen, pet dander, molds, etc. Most people diagnosed with allergic asthma will also have a diagnosis of hay fever or rhinitis. For these patients, exposure to allergens causes the bodys immune system to produce immunoglobulin E, an antibody that attaches to certain cells and causes them to release chemicals creating an allergic reaction. When this happens, common symptoms are sneezing, itchy/watery eyes, severe allergic reactions , and increased airway sensitivity.
Non-eosinophilic asthma includes neutrophilic, smooth-muscle mediated and mixed cells. People in this subgroup have few to no eosinophils in test results, and do not respond well to inhaled corticosteroids.
Gender Differences In Copd
From 1998-2009, more women were diagnosed with COPD than men. Although overall death rates from COPD were lower in women than men, death rates in men decreased during this time period while death rates among women stayed the same. No one is certain why this is, but there are differences in the way men and women are diagnosed and treated for COPD that may contribute to the disparity.
Even when they have the same symptoms, women with COPD are often misdiagnosed initially as having asthma, are less likely to be referred to specialists, and are therefore less likely to be treated quickly, accurately, and effectively for COPD compared to men. Women with COPD also report more severe symptoms and experience a lower quality of life. Women who are dependent on oxygen have a 50% increased risk of death from COPD as opposed to men on oxygen.
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Tips To Help Prevent Exercise
To prevent exercise-induced asthma, suggestions include:
- Make sure that your asthma is being well managed, as this will make exercise-induced asthma less likely to occur.
- Always carry your reliever medication and spacer with you.
- If written on your Asthma Action Plan, take your reliever medication up to 15 minutes before warming up.
- Warm up before exercise as usual.
- During exercise, watch for asthma symptoms and stop and take your reliever medication if symptoms appear. Only return to exercise if your asthma symptoms have been relieved. If asthma symptoms appear for a second time during exercise, take your reliever medication again until symptoms have been relieved. It is not recommended that you return to the activity.
- After exercise, cool down as usual. Asthma symptoms can occur up to half an hour after exercise. Make sure you take your reliever medication if you have symptoms after exercise.
Asthma And Smoking Reducing Risk
You can reduce the risk of worsening your asthma by avoiding cigarette smoke. Some suggestions include:
- Quit smoking.
- Make your home completely smoke free ask guests not to smoke in your house.
- Avoid smoky places, such as outdoor areas of pubs, bars and cafes.
If you wish to use nicotine replacement therapy or quitting medications to stop smoking, talk to your doctor or pharmacist about which products are suitable for you. Use of e-cigarettes to quit smoking is not recommended as they have not been approved by the Therapeutic Goods Administration and they contain many chemicals that are potentially toxic.
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How Is Early Childhood Health Linked With Asthma
The lungs grow and develop during childhood. Babies born early have immature lungs. They are more likely to wheeze and cough during childhood.2 Some children outgrow these symptoms, while others continue to have breathing problems into early adulthood.3
Age three years seems to be an important landmark for lung health. Children who had pneumonia before they were three years old have lower lung function up to age 26 years.4 Early pneumonia is also linked with having twice the risk of asthma up to age 29, compared with people who did not have pneumonia. Having asthma before age three years affects lung function growth, whereas asthma that starts later does not.5
Early lung problems may put children on a path to abnormal lung development.3 But there are still a number of questions. Does early damage to the airways mean that the airways do not grow normally? Or does being born with lower lung function make children more likely to have lifelong lung problems? Studies have not provided the answers yet.
How Is Copd Diagnosed
COPD is estimated to be undiagnosed or misdiagnosed in about 50% of the 24 million men and women estimated to have COPD in the U.S. Many people are not aware they have it until symptoms such as coughing, shortness of breath , increased mucus production, and wheezing develop slowly over time. Many patients fail to report symptoms to their doctors because they assume these symptoms are a normal part of aging and are unaware of the symptoms of COPD. Many smokers just assume that the symptoms they are experiencing are due to smoking and not to something more serious. However, diagnosing patients with COPD from symptoms alone leads to errors of overdiagnosis. Studies have shown that the best method for diagnosing COPD is spirometry, which is a common and inexpensive office test that measures lung capacity. Spirometry can detect COPD even before symptoms become apparent and can be used to track the progression of COPD and determine if a treatment is working. Other methods used to diagnose COPD include chest x-rays, computed tomography scans, listening to the lungs with a stethoscope, and arterial blood gas tests that determine oxygen and carbon dioxide levels in the blood. In general, spirometry is used to detect airflow obstruction and low-dose CT is used to diagnose emphysema. Spirometry is usually used for standard COPD screening because its safe and inexpensive, but CT screening is sometimes necessary to diagnose people with emphysema who dont also have airflow obstruction.
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How Does Exercise Trigger Asthma Symptoms
Doctors think they know why some peoples asthma is made worse by exercise .Normally, people breathe through their nose. Your nose acts as an air filter. It controls the temperature and humidity of the air before it reaches your lungs.When you exercise, your body wants more air. Your breathing speeds up to get more air. You start breathing through your mouth, so you can gulp down more air. But air that comes through your mouth has not been filtered, warmed, or humidified by your nose. This means the air that gets to your airways is cooler and drier than usual.If you have asthma, your extra-sensitive airways dont like cool dry air. Your airways react: the muscles around the airways twitch and squeeze tighter. Tighter airways mean there is less space for the air to pass through. This makes you wheeze, cough, and feel short of breath.
Asthma Triggers Symptoms & Warning Signs
The two main types of asthma triggers are irritants, which bother airways, and allergens, which cause reactions such as watery eyes, sneezing or a runny nose.
Asthma triggers are specific to each person living with asthma. People living with asthma need to know what triggers their own asthma and how to avoid those triggers. Some common triggers include:
|changes in breathing patterns||Stress|
Learning which irritants and allergens trigger your asthma will help you avoid those triggers and manage your asthma. Although its not possible for you to control certain triggers, like pollen levels, there are many ways to make your home trigger-free for easier breathing.
Asthma symptoms also vary for each person. Common symptoms are:
- Shortness of breath
- Chest tightness
Most people with asthma feel that their asthma is acting up. These signs let you know something is wrong before your asthma gets worse. Early warning signs include:
- Breathing changes
- Chin itchiness
It is important to know your asthma triggers, symptoms and warning signs so you can use medication promptly and appropriately.
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Smoking Causes Damage To Airways
Your lungs are lined by tiny hairs called cilia. These move in a wave-like motion to sweep dust, pollens and other irritants out of your lungs. Cigarette smoke damages these tiny hairs.
This means your lungs will be less able to clean themselves, which can lead to mucus and toxic substances collecting in the lungs, increasing the risk of lung infection. Smoking can also damage the small airways and air sacs within the lungs, causing lung disease including emphysema.
As lung disease slowly worsens over time, it can limit airflow, causing shortness of breath. Quitting smoking reduces your risk of developing lung disease, and slows down any worsening of lung disease if you already have it.
Signs And Symptoms Of Coronavirus And Lung Cancer
Coronavirus symptoms can vary from mild to severe illness and death. But the Center for Disease Control identifies that the following symptoms may appear 2-14 days after exposure:
- Shortness of breath
It is still a challenge to diagnose coronavirus in lung cancer patients because many of the symptoms are the same, such as:
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Asthma Outcomes And The Whole Patient: Beyond The Pharmacological
The stepped pharmacotherapy strategy familiar from asthma guidelines may encourage the belief that stronger medication is needed when control is poor. Some patients do indeed have severe, therapy-resistant disease, requiring more effective pharmacotherapy. However, good-quality management can often improve outcomes even in this group , and psychosocial problems and non-adherence are common in people with asthma of all severity levels. Asthma is incurable and usually a lifelong condition, and the recurrent and unpredictable experience of having to struggle to breathe is frightening and disturbing, potentially undermining overall wellbeing. If other life stressors are present, such as co-morbidity, psychosocial disadvantage or a lack or resilience to stress resulting from genetic or environmentally factors, some will experience symptoms as more distressing and may not cope with them well.
Over-breathing and abnormal breathing patterns are commonly associated with anxiety, and breathing-control exercises have long been used as a treatment for anxiety and panic. Hyperventilation and other abnormalities in breathing have also been associated with asthma, implicated as triggers for bronchoconstriction and the production of asthma-like symptoms in patients of all levels of objective asthma severity .
Asthma Symptoms Acute Vs Chronic
In medical related matters, acute simply means short term, and chronic means long term. Although asthma is a chronic disorder, since it usually lasts a long time , you can have both chronic and acute asthma symptoms. If someone does not properly manage their asthma, they can have regular chronic symptoms for many weeks, months, or even years. For example, they could experience a regular cough that lasts a long time if not managed properly.
Then on top of the regular chronic cough, they may also sometimes experience an acute asthma worsening that leads to a symptom such as shortness of breath. This could perhaps be due to getting a cold, or exposure to pollen or air pollution.
When someone has asthma, it is very important to keep it well controlled so that there are no chronic asthma symptoms. You cant avoid all asthma symptoms all the time, but in general the symptoms should be uncommon and mild.
It is also very important to monitor your asthma so that you notice when there are acute asthma symptoms starting and can take the necessary measures to get it under control before it leads to an asthma attack. A written asthma action plan from your doctor can be very helpful in guiding your treatment decisions.
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- Medical history
- Test results, such as a lung function test