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Lung Disease

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What do healthy lungs do?

Lungs are the organs that allow us to breathe. Lungs provide a huge area (as large as a football field) for oxygen from the air to pass into the bloodstream and carbon dioxide to move out. The cells of our bodies need oxygen in order to work and grow. Our cells also need to get rid of carbon dioxide.

During a normal day, we breathe nearly 25,000 times, and take in (inhale) large amounts of air. The air we take in contains mostly oxygen and nitrogen. But air also has things in it that can hurt our lungs.Bacteria, viruses, tobacco smoke, car exhaust, and other pollutants can be in the air. People with lung disease have difficulty breathing. These breathing problems may prevent the body from getting enough oxygen.

diagram of the lungs

Is lung disease a common health problem?

Yes. More than 35 million Americans have an ongoing (or chronic) lung disease like asthma or chronic obstructive pulmonary disease (COPD). If all types of lung disease are lumped together it is the number three killer in the United States. It causes 1 in 7 deaths in this country each year.

The term lung disease refers to many disorders affecting the lungs such as:

Should women be worried about lung disease?

Yes. The number of women diagnosed with lung disease in the United States is on the rise. The percentage of women dying from lung disease in this country is also increasing.

Here are some other reasons why lung disease is an important health concern for women:

What types of lung disease are most common in women?

Three of the most common lung diseases in women are asthma, chronic obstructive pulmonary disease (COPD), and lung cancer. Other important but less widespread lung problems that affect women include:

This FAQ gives detailed information on asthma, COPD, and lung cancer. For more information on other lung diseases, please visit the web sites of the following organizations:

Asthma

Asthma is an ongoing or chronic disease of the airways in the lungs called bronchial tubes. Bronchial tubes carry air in and out of the lungs. In people with asthma, the walls of the airways become swollen (inflamed) and oversensitive. Asthmatic airways overreact to things like viruses, smoke, dust, mold, animal hair, roaches, and pollen. When they react they get narrower. This limits the flow of air into and out of the lungs. Asthma causes wheezing, coughing, tightness in the chest and trouble breathing.

About 20 million Americans have asthma. Women are more likely to have asthma than men. In the United States more than 11 million women had asthma in 2003 compared to 8.2 million men.

The percentage of women, especially young women, diagnosed with asthma continues to the rise in the United States. Researchers are not sure why. But there are several theories.

Many experts think that more contact with indoor and outdoor allergens and pollution plays a role in increasing the rate of asthma. Exposure to house dust mite and cockroach allergens as well as tobacco smoke is linked to an increased risk of asthma.

Chronic Obstructive Pulmonary Disease (COPD)

COPD is a term that describes related diseases: chronic obstructive bronchitis and emphysema. These conditions often occur together. Both diseases limit airflow out of the lungs and make breathing difficult. COPD gets worse with time.

In almost 90% of cases, smoking is the cause of COPD. The single most important thing a person can do to reduce their risk of lung disease is to stop smoking.

COPD is the fourth leading cause of death in the United States. In 2003, more than 7.2 million women had COPD in this country. And more women have died from COPD than men every year since 2000.

In COPD, there is inflammation of the tubes (bronchial tubes) that carry air in and out of the lungs. This ongoing irritation thickens and scars the lining of the bronchial tubes. The irritation also causes the growth of cells that make mucus.

If the airways become thickened enough to restrict air flow to and from the lungs, the condition is called chronic obstructive bronchitis. The excess mucus leads to a constant cough typical of this illness.

But early signs of COPD are often hard to detect. People often decrease their activity level without even realizing it. And some people just assume age or weight gain is the cause of their lack of energy.

In emphysema, the walls between the air sacs (alveoli) are destroyed and the lung tissue is weakened. Normally oxygen from the air goes into the blood through these air sacs. But as the air sacs become damaged, the lung has less surface area. This interferes with the movement of oxygen from the air into the blood. So less oxygen passes into the blood of people with emphysema. Emphysema causes shortness of breath, cough and wheezing (squeaky sound when breathing).

Still, the early signs of emphysema are often very hard to detect. Since 2004, the rate of emphysema in American women has increased by 5 percent. In contrast, the rate in men has decreased by 10 percent. In 2003, approximately 1.4 million women had emphysema.

Lung cancer

Lung cancer is a disease in which abnormal (malignant) lung cells divide without control. These cancerous cells can invade nearby tissues and/or spread to other parts of the body. There are two major kinds of lung cancer: non-small cell lung cancer and small cell lung cancer. Non-small cell lung cancer is the most common kind.

Lung cancer is the leading cancer killer of American women. Lung cancer will kill more than 68,000 women this year. And more and more women are being diagnosed with this disease in the United States. Smoking causes 87% of all cases of lung cancer.

How would I know if there was something wrong with my lungs?

Early signs of lung disease can be easy to overlook. Often people with early lung disease just say they don't have much energy.

Some common signs of lung disease include:

If you have any of these symptoms, call your doctor immediately. She will be able to pinpoint what is wrong with you.

How can I decrease my chances of lung disease?

Things you can do to reduce your risk of all lung diseases include:

What causes lung disease?

There are many known causes of lung disease. Still, the causes of many lung diseases are still not known. Some known causes of lung disease include:

How can I find out if I have asthma?

Asthma can be hard to diagnose. This is because the signs of asthma are similar those of other lung diseases. The signs of COPD, pneumonia, bronchitis, pulmonary embolism, anxiety and heart disease can all be confused for asthma. It is important to note that women are misdiagnosed with asthma when they really have COPD more often than men.

To figure out if asthma is causing your discomfort, the doctor will first ask about your symptoms and health history. She will then do a physical exam.

To confirm the diagnosis, the doctor may run any of the following tests:

The doctor may also suggest other tests to make sure another disease is not causing your problems. These include:

How is asthma treated?

Asthma is a chronic disease that cannot be cured. But medicines and lifestyle changes can help control the symptoms. One way to help relieve asthma is to avoid things in the environment that make symptoms worse. A number of types of medicines are also used to treat asthma. Most work by opening the lung airways and reducing inflammation.

The medicines used to treat asthma fall into two groups: quick-relief and long-term control.

Quick-Relief

Quick relief medicines are used only when needed. They should be taken when symptoms are getting worse to prevent a full-blown asthma attack.  They can also be used to stop attacks once they have started. These medicines relieve symptoms in minutes. Short-acting inhaled bronchodilators (albuterol and pirbuterol) are two commonly used quick relief medicines. They quickly relax tightened muscles around the airways. 

Long-Term Control

Long-term control medicines or controller medicines are taken every day, usually over a long period of time. Over time, these medicines relieve symptoms and prevent asthma attacks in those with mild or moderate persistent asthma.

These medications help control inflammation in the lungs. To be effective, they must be used every day. These medicines are not intended to relieve symptoms immediately. Some may even take a few weeks to have their full effect.

Some long-term control medicines include:

Staying away from triggers, taking your medicine consistently, and regular visits to the doctor will help you take control of asthma.

I just found out I'm pregnant, should I still take my asthma medicines?

It is very important to call your doctor as soon as you find out you're pregnant. As your doctor will explain, it is extremely important to manage your asthma symptoms when you are pregnant. Taking asthma medicines and avoiding triggers helps make sure the baby gets enough oxygen. Untreated asthma can harm a growing fetus.

Many asthma medicines seem to be safe for use during pregnancy. Inhaled medicines are usually preferred for pregnant women. These medicines are less likely to be passed on to the baby than oral medicines. However, sometimes pregnant women need oral medicines to control symptoms. Talk with your doctor about the safety of asthma medicines during pregnancy. You should also talk to your doctor about getting a flu shot after the first trimester. The flu can be very serious for pregnant women with asthma.

How do I find out if I have chronic obstructive pulmonary disease (COPD)?

If you smoke, have a cough that won't go away, and shortness of breath see your doctor. To figure out if you have COPD, doctors usually:

Your doctor may also suggest other tests like chest x rays to make sure something else is not causing your problems. X rays may allow the doctor to see if another lung disease or heart disease is causing your symptoms.

How is chronic obstructive pulmonary disease (COPD) treated?

The damage to the lungs in COPD cannot be repaired. But treatment can relieve symptoms. The only thing that can slow the progress of the disease is to stop smoking. So if you're a smoker, the single most important thing you can do is stop smoking. This slows down COPD and minimizes future damage to the lungs.

Medicines can also help you feel better. Common medicines used to treat COPD include:

Sometimes doctors also recommend the following for women with COPD:

How do I find out if I have lung cancer?

Usually there are no warning signs of early lung cancer. But if there is a sign, it is usually a cough. By the time most women have symptoms, the lung cancer often has advanced to more serious stages.

Symptoms of lung cancer may include:

If you have any of these problems, call your doctor as soon as possible. The doctor will ask about your personal and family health history, smoking history, and exposure to harmful substances. She will also do a physical exam and may suggest some tests.

Common tests for lung cancer include:

I smoke, should I get tested for lung cancer?

Talk to your doctor. Some doctors suggest testing smokers over 50 years of age for lung cancer. But experts still are not sure if routine testing (screening) saves or prolongs lives.

Testing for cancer before a person has any symptoms is called screening. Screening tends to find cancers early when it is easier to cure and treat. Screening high-risk groups (like smokers) for lung cancer is a controversial issue.

Many studies show that using x rays to screen smokers for lung cancer does not save lives. For this reason, the National Cancer Institute and the U.S. Preventive Services Task Force (USPSTF) do not recommend screening for lung cancer.  It is important to note that the USPSTF does not recommend against screening either. More studies are needed to show the exact risks and benefits of screening for lung cancer. Some groups do recommend screening in at-risk groups including smokers over 45 years and people exposed to lung-damaging substances at work.

Computerized tomography scans (CT scans) show promise as a screening tool. The National Cancer Institute is doing an important study called the National Lung Screening Trial (NLST) to answer important questions about routine testing for lung cancer. This study will show if screening with CT scans and/or chest x rays can save lives.

How is lung cancer treated?

Most lung cancer is hard to treat. The best way to fight lung cancer is to never start smoking or to stop smoking.  If you need help to stop smoking, talk to your doctor. A government website all about quitting smoking can also help you kick the habit.

Lung cancer can be treated in a number of different ways including a combination of surgery, radiation, and chemotherapy. Most of the time treatment does not cure the cancer but stops it from spreading and relieves symptoms. Your specific treatment will depend on:

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 injected into a vein or taken as a pill.

Surgery is used to remove tumors.

To find out about research studies on new treatments for lung cancer, visit the website of the National Cancer Institute and click on "clinical trials."

For more information . . .

You can find out more about lung disease by contacting the National Women's Health Information Center (NWHIC) at 1-800-994-9662 or the following organizations:

National Heart, Lung, and Blood Institute
Phone Number: (301) 592-8573
Internet Address: http://www.nhlbi.nih.gov/index.htm

American Lung Association
Phone Number: (800) 586 4872
Internet Address: http://www.lungusa.org

National Cancer Institute
Phone Number: 1-800-4cancer
Internet Address: http://www.cancer.gov

National Institute of Allergy and Infectious Diseases
Phone Number: (301) 496-5717
Internet Address: http://www3.niaid.nih.gov

Centers for Disease Control and Prevention
Phone Number: (800) CDC-INFO
Internet Address: http://www.cdc.gov

All material contained in the FAQs is free of copyright restrictions, and may be copied, reproduced, or duplicated without permission of the Office on Women's Health in the Department of Health and Human Services; citation of the source is appreciated.

Reviewed by:

Gail Weinmann, MD
Director, Airways Biology and Disease Program
National Heart, Lung, and Blood Institute

James Kiley, Ph.D.
Director, Division of Lung Diseases
National Heart, Lung, and Blood Institute

Hannah Peavy,M.D.
Medical Officer, Division of Lung Diseases
National Heart, Lung, and Blood Institute

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Current as of March 2006

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