LUNG CANCER

COPD

TISIS (TB)

FACTS ABOUT ASTHMA


What are the symptoms of lung cancer?

Lung cancer at an early stage may not cause any symptoms but when the tumor has grown, it may manifest itself by the following signs and symptoms:

  • cough
  • chest pain
  • coughing out of blood
  • chest infection
  • malaise
  • poor appetite and weight loss
  • shortness of breath
  • drowsiness
  • clubbing of the fingers (thickening of the fingertips with typical nail changes)
  • bone pain

What are the tests used to diagnose lung cancer?

  • Chest x-ray
  • Sputum microscopy and cytology
  • Lymph node biopsy
  • Pleural biopsy
  • Fiberoptic bronchoscopy
  • Percutaneous needle lung biopsy
  • Exploratory surgery

Is it possible to detect lung cancer before it causes symptoms?

There are no reliable blood tests that can detect lung cancer at an early stage.

Screening tests such as sputum cytology and chest x-ray may detect cancer  at an earlier stage.

What is "staging" of lung cancer?

Staging is a term used to describe the size and extent of spread of the tumor.  The stage of the cancer enables the doctor to choose the best treatment for the patient as well as advise the patient on the most likely outcome of treatment. 

What are the tests used to stage lung cancer?

  • Chest x-ray
  • Fiberoptic Bronchoscopy
  • Blood tests
  • Ultrasound or Isotope scan of the liver
  • Isotope scan of the bone
  • Biopsy of an obvious tumor mass or a lymph node
  • CT-scan of the chest
  • Mediastinoscopy
  • Mediastinotomy
Are there differences in the treatment approaches to lung cancer?

Yes.

For early stages of squamous cell cancer, adenocarcinoma and large cell cancer, surgery is an important mode of treatment.

Chemotherapy or drug treatment is the mainstay of treatment for small cell cancer and later stages of the other cancers.  Radiotherapy or cobalt therapy is another treatment modality and may be used alone or in combination with surgery and chemotherapy.

What would be the major findings that would suggest that an operation is not going to be useful?

  • Any cancer that has spread outside the chest or the lung.
  • Cancer invading or pressing on the major airways and near the main division (carina) of the bronchial tree.
  • Cancer invading the trachea.
  • Invasion of the major blood vessels or the heart.
  • Lymph node involvement located at the neck or on the opposite side of the chest.
  • Fluid around the lungs.
  • Loss of voice or hoarseness.

How does one know if the patient can tolerate the operation?

Patients will undergo various tests to measure lung function.  His general health status will also be assessed to determine if he can withstand and survive surgery.

Are there different types of  lung cancer?

Yes.

There are four major kinds of cancer that can develop in the lungs and each can be recognized by its appearance when examined under a microscope.

These types are:

  • Squamous cell cancer
  • Adenocarcinoma
  • Large cell carcinoma
  • Small cell carcinoma

What is "COPD"?

Doctors often use the term "COPD" or chronic obstructive pulmonary disease to refer to "Emphysema" and "Chronic Bronchitis."  These two diseases frequently occur together since they usually have the same cause, that is, cigarette smoking, and have the same effect, which is obstruction of the air passages in the lungs. 

What is "Chronic Bronchitis"?

Chronic Bronchitis is a result of repeated and long term swelling and irritation of the lining of the bronchi (tubes in the lungs carrying oxygen in and bringing carbon dioxide out of the lungs).  A combination of this swelling and excess amount of mucus production results in narrowing of air passageway, and eventually, permanent damage occurs.

 What is "Emphysema"?

In Emphysema, the air sacs in the lungs are permanently enlarged and their walls are destroyed.  As air becomes trapped in these sacs, they press against the adjacent air passages - in effect causing obstruction.  In addition, the air passages tend to collapse because of structural abnormalities in their walls.  As a result, the lungs do not work efficiently and breathing becomes difficult. 

What causes "COPD"?

Cigarette smoking is a major cause of COPD.  Exposures in the work place to certain dusts (e.g. silica, coal, asbestos, cotton or grain) and cadmium may contribute to the development of the disease.  Exposure to outdoor air pollution like sulfur, nitrogen dioxide and ozone, may also contribute to lung damage.  Emphysema can also be caused by a genetic deficiency of a-1-antitrypsin.

What are the symptoms?

For chronic bronchitis, cough and excessive mucus/phlegm production are early and common symptoms.  Wheezing and difficulty in breathing develop later.

For Emphysema, difficulty in breathing is the most important complaint.  This may only be episode at first, but may worsen over time such that a short walk or any movement may bring in breathlessness.  The extra work of breathing may also strain the heart and cause heart failure.

Danger signs for which the patient should seek help are the following:

  • fever
  • increasing cough
  • change in color or quantity of sputum
  • increasing shortness of breath
  • dizziness
  • loss of appetite
  • swelling of the feet and ankles

How will my doctor diagnose COPD?

A complete history of your symptoms and a thorough physical examination are important.  A chest x-ray film will show abnormalities suggestive of COPD.  Other sophisticated tests such as spirometry, nitrogen wash-out studies are also available to confirm the diagnosis.

How does it attack?

A person with the disease does not develop the disease suddenly.  There is a history of repeated bouts of colds and cough, with the cough becoming persistent.  The most common complaint that brings the patient to a doctor is the increasing episodes of shortness of breath, which may be misinterpreted as asthma or heart disease. 

Is COPD contagious?

No.  One cannot get it from someone else.  COPD is usually a product of various insults to the lung like cigarette smoke, occupational dusts and outdoor ambient air pollutants. 

Who gets "COPD"?

Males in the 50 to 70 year age group have the highest incidence.  Women can get COPD too but not as often as men.  Men diagnosed to have COPD usually have a heavy and long history of smoking.  Frequently, they live in areas where air pollution is a problem.

How is "COPD" treated?

Although COPD cannot be cured because the changes have become irreversible, it usually can be controlled, and symptoms relieved.  Pharmacologic therapy includes bronchodilators, corticosteroids, antibiotics and mucolytic expectorants.  Non-pharmacologic maneuvers include smoking cessation, special exercises and a modified diet. 

COPD is a serious disease.  It has damaged your lungs.  It can affect your heart.  You cannot treat it yourself, seek professional help.


Ano ang tisis (TB)?

Ang TB ay isang impeksyong sanhi ng bakteryang Mycobacterium tuberculosis.  Sa baga karaniwan ang sakit na ito pero pwede ring maapektuhan ang ibang bahagi ng katawan. 

Paano ako nagkaka-TB?

Dura ang karaniwang pinagmumulan ng mikrobyo ng TB na lumulutang sa hangin.  May mga taong nagkaka-TB kapag nakalalanghap ng mga mikrobyong ito.  Mayroon namang hindi.  Sa ilang tao, ang mga mikrobyo ay nananatili muna nang matagal sa mga baga bago dumami ang mga ito.  Ang may mahinang pangangatawan dahil sa kakulangan ng sustansya, dahil sa katandaan o sakit na gaya ng AIDS ay mas madaling nagkaka-TB. 

Ano ang mga tanda ng panganib ng TB?

  • ubong higit sa tatlong (3) linggo
  • ubong may dugo
  • lagnat at pagpapawis nang higit sa tatlong (3) linggo
  • pananakit ng likod nang lagpas sa tatlong (3) linggo
  • pagbaba ng timbang ng katawan

Kung nakakaramdam ka ng mga nasabing tanda at sintomas, kumunsulta ka agad sa duktor at ipasuri mo ang iyong plema nang tatlong ulit para sa mikrobyo ng TB. 

Ano ang mga pagsusuri sa TB?

  1. Ang pagmimikroskopyo ng laway at plema ay isang simple at maasahang paraan ng pagsusuri.
  2. Ang x-ray ng dibdib ay isa ring mahalagang paraan ng pagsusuri para ma-screen ang mga tao sa lugar na laganap ang TB ng baga.
  3. Tuberculin test.  Ang positibong tuberculin test ay maaaring tanda ng dating pagkakaroon ng TB o ng isang aktibong sakit ngayon.  Ang negatibong tuberculin test ay hindi laging nagpapahayag ng kawalan ng TB.  Ang masamang nutrisyon, at ang mga sakit na gaya ng impeksiyong HIV, ang malalang TB, ay maaaring magbigay ng maling negatibong resulta.

Kailangan bang ma-ospital?

Hindi.  Karamihan sa mga pasyente ay maaaring gamutin sa bahay maliban sa mga:

  • nahihirapang huminga
  • umuubo na may kasamang dugo
  • mahinang-mahina ang katawan
  • nangangailangan ng maraming pagsusuri

Kung ako'y may TB, ano ang dapat kong gawin upang hindi mahawa ang pamilya ko?

  1. Inuming lagi ang gamot.  Mabilis na binabawasan ng panggagamot ang pagiging nakakahawa, karaniwan sa loob ng dalawang linggo.
  2. Takpan ang bibig at ilayo ang mukha sa kaharap kung umuubo.
  3. Huwag dudura sa paligid.  Dumura sa isang natatakpang lalagyan.
  4. Kung maaari, matulog sa ibang silid na malayang nahahanginan.  Dinadalang palabas ng hangin ang mga mikrobyo ng TB.
  5. Payuhan ang iyong pamilya na magpasuri ukol sa TB.

Kailangan din bang uminom ng gamot ang mga kaanak at ibang kasama sa bahay upang maiwasan na masapian ng TB?  Kung kailangan, anu-anong gamot?

Oo.  Ang maagang panggagamot upang makaiwas ay dapat gawin sa mga bata kung sila ay:

  • bagong nahawa;
  • positibo sa tuberculin test at kulang sa nutrisyon, nagkatigdas, may pertussis, may leukemia o nasa ilalin ng immunosuppressive therapy. 

Binibigyan sila ng Isoniazid (INH) 10 mg/kg na iniinom nang minsanan araw-araw sa 12 buwan. 

Lahat ng kasama sa bahay na may malakas na reaksyon sa tuberculin skin test (8 mm  o higit pa) at may gulang na 18 hanggang 35 taon ay maaaring uminom ng gamot upang makaiwas sa sakit.  Ang ipinapayong rehimen ay Isoniazid (INH) at pangalawang gamot (maaaring Rifampicin Ethambutol).  Ang INH-Ethambutol ay iinumin araw-araw sa loob ng anim (6) na buwan samantalang ang rehimeng INH-Rifampicin ay iinumin nang apat (4) na buwan. 

Ano ang rekomendadong gamot pang-TB sa baga sa Pilipinas?

Unang dalawang buwan:  Rifampicin, INH, Pyrazinamide at Ethambutol (o Streptomycin) araw-araw.

Susunod na apat na buwan:  Rifampicin at INH araw-araw.

Ano ang mangyayari kung ititigil ko ang aking gamot pagkalipas ng isang buwan?  Ano ang gagawin ko?

Ang mga mikrobyo ng TB ay magsisimula na namang dumami nang mabilis at lilitaw na naman ang mga tanda mo ng tisis.  Ang mga mikrobyo ng TB ay maaaring lumakas laban sa mga gamot at magiging mahirap na gamutin kang muli.

Magsimula ka uling maggamot. 

Kung ako'y buntis, maitutuloy ko ba ang panggagamot?

Huwag kang mag-alala.  Ang INH, Rifampicin at Ethambutol ay ligtas.  Hindi inirerekomenda ang Streptomycin dahil maaari itong maging sanhi ng pagkabingi ng sanggol.  Magdahan-dahan sa paggamit ng Pyrazinamide dahil wala pang sapat na karanasan sa gamot na ito sa mga buntis. 

Pwede bang pasusuhin ng inang may TB ang kanyang sanggol?

Oo.  Napakaliit ng panganib sa sanggol ng gamot sa TB.  Gayunpaman, dapat tanungin ang ina at suriin lagi ang sanggol ukol sa mga tanda ng pagkakalason.  Pinapayuhan ang ina na uminom ng gamot pagkatapos lamang magpasuso.  Gumamit ng gatas sa bote sa susunod na pagpapasuso pagkatapos uminom ng gamot.  Iwasang magpasuso kung ang sanggol ay ginagamot din sa TB. 

Pwede ba akong magtrabaho kahit ginagamot sa TB?

Pwede, pero mainam ding magpahinga muna nang isa o dalawang buwan hanggang bumuti ang iyong pakiramdam. 

Ako ba'y hindi makakaranas ng side effects kung lulunok ako ng maraming tableta?

Maaaring maramdaman mong gusto mong maduwal o mahilo pagkatapos lumunok ng gamot.  Gayunpaman, unti-unti kang masasanay dito.  Kung makakaranas ka ng panlalabo ng paningin, panghihina ng pandinig, pananakit ng kasu-kasuan o makakapansin ng paninilaw ng mga mata, itigil mo ang mga gamot at kumunsulta agad sa iyong duktor.

PAALALA sa pasyente

  • Gagaling ka kung walang tigil ang panggagamot mo nang anim (6) na buwan.
  • Kapag nasimulan mo ang panggagamot sa TB, kumunsulta ka sa duktor mo minsan isang buwan para sa pagsusuri at dagdag na payo tungo sa iyong lubusang paggaling.
  • Takpang lagi ang bibig kapag umuubo at dumura lamang sa isang natatakpang sisidlan.
  • Huwag mong titigilan ang panggagamot kahit umiige na ang iyong pakiramdam.  Ang mas mabuting pakiramdam ay hindi laging tanda na ikaw ay magaling na.
  • Kumunsulta agad sa duktor kapag nakaramdam ka ng side effects na gaya ng panlalabo ng paningin, pagiging mabuway, panghihina ng pandinig at paninilaw ng balat.
  • Iwasan ang paninigarilyo, pananabako at pag-inom ng alak.
  • Maaari kang makihalubilo sa iyong pamilya at sumalo sa pagkain nila pero lagi kang iinom ng gamot.

What is Asthma? 

Asthma is a condition that effects the size and shape of the air passage in the lungs and leads to breathing difficulties.

What happens during an episode of asthma?

During an asthma episode:

  • The lining of the air passages or airways become swollen (inflamed).
  • The airways produce thick mucus.
  • The muscles around the airways tighten and make the airways narrower.

These changes in the airways block the flow of air, making it hard to breathe.

What are the main symptoms of asthma?

The main symptoms of asthma are:

  • Shortness of breathe
  • Wheezing
  • Tightness in the chest
  • Cough lasting more than a week

Not all people with asthma wheeze.  For some, coughing may be the only sypmtom of asthma.  Coughing often occurs during the night or after exercise.

What causes Asthma?

 The basic cause of asthma is not yet known.  People with asthma have airways that are irritable or very sensitive to things that do not bother people who do not have asthma.  These things are called triggers.  If you are an asthmatic and you are near or come in contact with triggers, they may start an asthma episode.  Your airways become swollen, produce too much mucus, and tighten up.

Common triggers for asthmas episodes include the following:

  • House dust mites present in dust
  • Cockroaches
  • Pollens from grass and trees
  • Molds
  • Irritant substances like:
    • cigarette smoke, wood smoke, scented products such as hair spray, cosmetics and cleaning products, strong odors from fresh paint, automobile fumes, air pollution
  • Infections in the upper airways, such as colds
  • Exercise or physical activity
  • Changes in weather or temperature
  • Showing strong feelings (crying, laughing)

Is there a cure for asthma?

Asthma cannot be completely cured, but it can be controlled.  You should expect nothing less.

How common are serious episodes of asthma?

Serious episodes seldom occur for most asthmatic but it is best to avoid or prevent them by monitoring your asthma, making regular visits to the doctor and by taking medications as prescribed.

Can you die from asthma?

Death from asthma is possible.  It can be avoided by careful monitoring and control of your asthma.

How can you monitor your asthma?

Monitoring your asthma can be done by using a simple device called a peak flow meter and by using an asthma diary to record your daily symptoms.

A peak flow meter is a device that measures how well air moves out of your lungs.  During an asthma episode, the airways of your lungs begin to narrow slowly.  The peak flow meter can be used to find out if there is narrowing in the airways hours -- even days -- before you have any symptoms of asthma.

By taking your medicine early (before symptoms) you may be able to stop the episode quickly and avoid a serious episode of asthma.

How can asthma episodes be prevented?

To prevent asthma episodes, you will have to work closely with your doctor to:

  • Develop a medicine plan or asthma control plan that keeps you from getting symptoms.
  • Play ways to avoid or reduce contact with your triggers.

How are asthma episodes controlled?

To control asthma episodes when they occur, you will have to work out an asthma control plan with your doctor that includes:

  • Treating symptoms early.
  • Doing the right things for any changes in symptoms.
  • Knowing when a doctor's help is needed and seeking help right away.

What can an asthmatic expect from treatment?

With proper treatment, most people with asthma will be able to:

  • Be active without having asthma symptoms.  This includes participating in exercise and sports.
  • Sleep through the night without having asthma symptoms.
  • Prevent asthma episode or attacks.
  • Have the best possible peak flow reading.
  • Avoid side effects from asthma medicines.

Knowing as much as you can about your asthma will make it easier for you to lead a completely normal and active life.

What steps can you take to ensure that your asthma does not interfere with your lifestyle?

Asthma is not frightening diagnosis and the condition can be monitored and controlled to allow the asthmatic to lead a completely normal lifestyle.

Asthma can be controlled if you make sure that you:

  • Communicate with your doctor regularly
  • Use your medications as prescribed
  • Lead a healthy lifestyle, and exercise regularly
  • Avoid or minimize the factors that trigger your asthma

Most importantly, understand what asthma is and learn to cope with it.