How Are Asthma And Lung Cancer Linked
There are no studies that clearly link asthma and lung cancer. One review paper showed that there might be a statistically increased risk.11 However, the authors looked closely at the data and concluded that the link could be explained by smoking or misdiagnosis of early cancer symptoms.
A large case-control study of people in Europe and Canada show that people with asthma actually had less risk of lung cancer.12 The authors explained that people with asthma may avoid things that increase the risk of lung cancer, such as smoking or certain types of work.
Symptoms Of Asthma And Copd
Asthma commonly starts in childhood. The symptoms;of breathlessness, chest tightness, cough and wheeze;are variable from day to day but are worse in the;night and early morning. Features of other allergic;conditions such as rhinitis and eczema may be;present and there may be a family history of asthma.;Typical triggers of asthma may be identified, such as;house dust, pollens and grasses.
Persistent dyspnoea that worsens with exercise;and progresses over time is suggestive of COPD.;Intermittent cough, with or without sputum;production, and wheeze, may also be present. There;may be a history of recurrent chest infections and;flares of respiratory symptoms. Onset;is usually in midlife, and there is typically a history;of cigarette smoking or exposure to other noxious;agents associated with indoor or outdoor pollution.
The coexistence of asthma and chronic obstructive;lung disease should be suspected in middle-aged or;older patients with:
- a history of cigarette smoking
- a diagnosis of asthma before the age of 40 years
- clinical features of both diseases.
Q: Whats The Difference Between Asthma And Copd
Asthma occurs frequently in people with a family history of the disease and often begins in childhood. Symptoms include shortness of breath, wheezing, coughing, and chest tightness, and these symptoms flare up during an asthma attack. At other times, symptoms may fade or become minimal.
COPD is different and usually strikes later in life. Most people diagnosed with COPD either used to smoke, or still do. Some symptomssuch as chest tightness and coughingare similar to asthma. Other symptoms, such as mucus production, are distinct to COPD. Unlike asthma, symptoms rarely ever fade completely.
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Genetic Evidence Supporting The Role Of Il
For decades numerous studies have tried to identify genetic links with the susceptibility to asthma, often in unique and highly homogeneous populations. However, most of these studies failed to provide clear and consistent associations that could help to identifying the genetic basis of asthma. This failure has led to questioning the importance of asthma genetics in developing new therapies. However, the rapid growth and development of more comprehensive areas of gene sequencing and genetics has facilitated studies in very large populations of subjects worldwide. In addition, the current paradigm of replicating results in more than one population is more likely to be useful.
A recent Australian genome-wide association study performed in over 2,000 asthmatics and 4,000 control individuals of European descent from Australia has identified three novel loci associated with asthma . Meta-analysis of their results with the results from the GABRIELS consortium identified seven putative novel asthma risk loci. A follow up analysis of these loci in asthmatic patients and controls from other studies has revealed the association of one SNP in intron 8 of the IL-6R gene in chromosome 1q21.3 with asthma risk. The presence of the minor T allele in this SNP was previously associated with increased levels of sIL-6R in serum -.
Medical History And Physical Exam
Your doctor will ask about your risk factors for asthma and your symptoms. They may ask also about any known allergies. This includes how often symptoms occur, what seems to trigger your symptoms, when or where symptoms occur, and if your symptoms wake you up at night.
During the physical exam, your doctor may:
- Listen to your breathing and look for symptoms of asthma
- Look for allergic skin conditions, such as eczema
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Similaraties And Differences In Acute Exacerbation Of Asthma And Copd
Pathology is different in exacerbation of asthma and COPD
Causes of acute exacerbation of asthma and COPD are different.
Different role of LABA and ICS in prophylaxis of exacerbation of asthma and COPD.
Treatment of acute exacerbation is similar in asthma and COPD.
Acute exacerbation of Asthma
Triggers of acute exacerbation of asthma are usually: allergens, infections , GE reflux, other triggers, sometimes and co-morbidity .
Pharmacotherapy of acute asthma exacerbation
corticosteroids . Other therapy
oxygen therapy ;
non -invasive mechanical ventilation ;
epinephrine rarely in a very serious asthma attack;
He/Ox rarely and MgSO4 intravenously rarely.
Acute exacerbation of COPD
Triggers of acute exacerbation of COPD are usually: infections , airpollution, GE reflux, sometimes and co-morbidity .
Pharmacotherapy of acute COPD exacerbation:
antibiotics in patients with severe exacerbation Other therapy:
oxygen therapy ;
non -invasive mechanical ventilation .
Monitoring Asthma At Home
Some people use a handheld peak flow meter to evaluate their breathing and determine when they need intervention, before their symptoms become severe. People who experience frequent, severe asthma attacks should know how to reach help quickly.
Peak expiratory flow can be measured using a small handheld device called a peak flow meter. This test can be used at home to monitor the severity of asthma. Usually, peak flow rates are lowest between 4 AM and 6 AM and highest at 4 PM. However, more than a 30% difference in rates at these times is considered evidence of moderate to severe asthma. People with moderate to severe asthma, particularly those who need daily treatment to control symptoms, often use a peak flow meter to take measurements and compare them to their personal best to help identify signs of worsening asthma or the onset of an asthma attack.
All people with asthma should have a written treatment action plan that was devised in collaboration with their doctor. Such a plan allows them to take control of their own treatment and has been shown to decrease the number of times people need to seek care for asthma in the emergency department.
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Comorbid Diseases Or Conditions
Comorbidity is the simultaneous existence of two or more diseases or conditions in an individual. Comorbidity for the purpose of respiratory disease in the CCDSS was defined as the co-existence in an individual of one of either asthma or COPD with diabetes, hypertension, mood and/or anxiety disorders, asthma or COPD .
For asthma, the prevalence of four comorbid diseases or conditions was calculated among those with and without asthma. For diabetes and mood and/or anxiety disorders, the prevalence was calculated for those age one and older; for hypertension, it was calculated for those aged 20 years and older and for COPD, for those aged 35 years and older.
For COPD, the prevalence of COPD was reported among those with and without each of the comorbid conditions. Therefore the prevalence of COPD was calculated among those with and without diabetes, mood and/or anxiety disorders, hypertension and asthma. The prevalence was calculated among those aged 35 years and older among all four comorbid diseases or conditions, corresponding to the reporting age for COPD.
The following case definitions were used for the comorbid diseases and conditions:
Mood and/or Anxiety Disorder
Individuals aged one and older with at least one physician billing claim listing a mood and/or anxiety diagnostic code in the first field, or one hospital discharge abstract listing a mood and/or anxiety diagnostic code in the most responsible diagnosis field in a one-year period.
How Often Should You Take Peak Flow Measurements
Peak flow readings can be taken on a regular basis or only at certain times. Regular monitoring may be useful when you are first diagnosed with asthma to determine your normal peak flow rates. Regular monitoring is also important when your asthma is unstable, or for those who do not notice symptoms when their asthma starts getting out of control. If your peak flow rate has dropped below your normal, you can act quickly to get control before it becomes serious.
Triggers are the things that can cause your asthma symptoms. Each person has their own set of asthma triggers. Over time you can figure out what your asthma triggers are and take steps to reduce your exposure.
There are two types of asthma triggers:
Here are some tips that can help you stay active:
- Do not start exercising if you have any asthma symptoms
- Warm up by starting at a slower paceincrease the pace slowly
- If you need to take a reliever inhaler before exercising, it should be taken about 10-15 minutes before the activity
- If you develop asthma symptoms while exercising, stop immediatelyuse your reliever inhaler and do not start again unless your symptoms are completely gone.
- Consider exercising indoors when outdoor conditions may trigger your asthma
- When exercising in cold weather, cover your nose and mouth with a scarf or cold weather mask
- If symptoms continue, your asthma may not be under controlwork with your health-care provider to improve your asthma management
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Diagnosing Asthma In A Young Child Can Be More Challenging Because:
- Children under six years of age are not generally able to do a lung function test
- Symptoms such as cough and wheeze are fairly common in very young children who do not have asthma
However, a diagnosis of asthma can be made in a young child. Your health-care provider will assess:
- What symptoms does the child have?
- When do the symptoms occur ?
- Is there a history of allergies or asthma in the family?
- Does the child have any signs of allergies
- Do the symptoms improve when taking asthma medications?
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Medications are usually needed for asthma, even if its mild asthma. New asthma medications are continually being discovered and there are several effective asthma drugs in the market that help get asthma under control.
There are two types of asthma medications: controllers and relievers.
How Can You Tell If You Have Asthma
It can be hard to tell if someone has asthma, especially in children under age 5. Having a doctor check how well your lungs work and check for allergies can help you find out if you have asthma.
During a checkup, a doctor will ask if you cough a lot, especially at night. He or she will also ask whether your breathing problems are worse after physical activity or at certain times of year. The doctor will then ask about chest tightness, wheezing, and colds lasting more than 10 days. He or she will ask whether anyone in your family has or has had asthma, allergies, or other breathing problems. Finally, the doctor will ask questions about your home and whether you have missed school or work or have trouble doing certain things.
The doctor may also do a breathing test, called spirometry, to find out how well your lungs are working by testing how much air you can breathe out after taking a very deep breath before and after you use asthma medicine.
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Key Differences Between Asthma And Copd
The following points will target on the fundamental differences between both kinds of reparatory diseases:
Staging And Treatment Of Chronic Obstructive Pulmonary Disease
The stages of COPD are defined primarily by lung function . This emphasises the important clinical message that the diagnosis of COPD requires the measurement of lung function. The stages of COPD suggested in the GOLD Guidelines are as follows. Stage 0: At risk, cough or sputum present but lung function normal. Stage 1: Mild COPD, FEV1/forced vital capacity <70%, with an FEV1 â¥80% predicted, with or without chronic symptoms. Stage 2: Moderate COPD, FEV1/FVC <70% and FEV1 % pred>30% and <80%. Stage 2 is split at an FEV1 of 50% pred since the existing data support the value of inhaled corticosteroids below an FEV1 of 50% pred but not above. Stage 3: Severe COPD, FEV1<30% pred and FEV1/FVC <70%.
In the GOLD guidelines, Stage 0 is a newly defined stage that was included to give a strong public health message that symptoms of chronic cough and sputum production should alert the clinician to the presence ofan ongoing pathophysiological process even when lung function is normal. This may progress to clinically significant COPD in a proportion of those exposed . The analogy that is perhaps most relevant is that mild hypertension in some but not all , with mild elevation of blood pressure will progress to clinically significant hypertension.
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Copd In The Canadian Population
CCDSS Case Definitions
Prevalent COPD Case Definition
The case definition of diagnosed COPD is: an individual aged 35 years and older having at least one visit to a physician with a diagnosis of COPD in the first diagnostic field, or one hospital separation with a diagnosis of COPD in any diagnostic field ever, coded by ICD-9 491-492, 496 or ICD-10-CA J41-44. This case definition for COPD was validated by Gershon and colleagues.Footnote 44
Only the first diagnostic field was used in physician billing claims data as not all provinces and territories had more than one diagnostic field. All fields were included from the hospital separation file as this database allows for the recording of up to 25 diagnoses.
Based on this definition, once a case is detected, it is a prevalent case for life regardless of future contact with health services. Consequently, once someone is identified as a case, they are always included in the database as a case. All jurisdictions identified cases occurring as of 1995, with the exception of Quebec which began in 1996 and Nunavut which began in 2005.
Incident COPD Case Definition
Incident COPD cases were identified in the year where an individual met the case definition for the first time. A run-in period of five years, where data were collected and not reported, was employed to partially account for the prevalence pool effect; i.e., to ensure that an incident case was not a pre-existing prevalent case. .
Canadian Chronic Disease Surveillance System
The CCDSS is a collaborative network of provincial and territorial chronic disease surveillance systems, led by the Public Health Agency of Canada . The CCDSS identifies chronic disease cases from provincial and territorial administrative health databases, including physician billing claims and hospital discharge abstract records, linked to provincial and territorial health insurance registry records using a unique personal identifier. Data on all residents eligible for provincial or territorial health insurance are captured in the health insurance registries; thus, the CCDSS coverage is near-universal with the exception of some small populations. Case definitions are applied to these linked databases and data are then aggregated at the provincial and territorial level before being submitted to PHAC for reporting at the provincial, territorial and national levels.
The CCDSS has expanded from its initial mandate of diabetes surveillance to include data on several additional chronic diseases and conditions including: hypertension, mental illness, mood and/or anxiety disorders, heart failure, ischemic heart disease, acute myocardial infarction, stroke, osteoporosis, arthritis and neurological conditions. Asthma and COPD were added to the CCDSS in 2012.
The data presented in this report and subsequent updates can be accessed on the Public Health Agency of Canada’s Public Health Infobase.
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Knowing The Differences Between Copd And Asthma Is Vital To Good Practice
This content was published in 2011. We do not recommend that you take any clinical decisions based on this information without first ensuring you have checked the latest guidance.
The Outcomes strategy for people with chronic obstructive pulmonary disease and asthma was launched in July 2011 by the Department of Health, with the overall aim to drive improvements in outcomes for patients.1;Once implemented, it is expected to help people to avoid lung disease and lead longer and healthier lives. The strategy recognises the role of community pharmacy in supporting the management of people with respiratory disease through medicines use reviews and new pharmacy services.
In addition, the introduction of national target groups for MURs in England, under amendments to the NHS Community Pharmacy Contractual Framework, aims to ensure the service is provided to those who will benefit most. One of the target groups is patients with asthma or COPD.2;Both diseases have a major impact in the UK in terms of mortality and morbidity3;and the aim of MURs with these patients is to support them to take their medicines as intended, increase their engagement with their condition and medicines, and promote healthy lifestyles, in particular stopping smoking.
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