Lower/Upper Respiratory Tract Infection Treatment
Asthma Treatment & Management
Asthma Management Program
Management of Smoking Cessation
Obstructive Sleep Apnea Treatment
Treatment of Sleep Disturbance
Oxygen Therapy Treatment
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Lung cancer is also known as pulmonary carcinoma or cancer of the lung. It occurs when DNA mutations develop in the cells/ tissues of the lungs leading up to uncontrolled growth in the tissues of the lung. By far, it is known to be the most common cancer in Asia.
1. Type: lung cancers can present as one of the following types:
- Non-Small Cell Lung Cancer (NSCLC): Most common type of lung cancer and constitutes nearly 85% of all lung cancers. The sub-types of NSCLC are as follows:
- Large cell carcinoma
- Squamous cell carcinoma (SqCC) (Epidermoid)
- Adenocarcinoma – accounts for majority of the NSCLC.
- Small Cell Lung Cancer (SCLC): It is also known as oat meal cancer and tends to spread (metastasize) quickly. This constitutes about 15% of the lung cancers.
- Mesothelioma: It is a rare cancer that develops in the mesothelial cells of the pleural or peritoneal surfaces. It usually arises in the pleural membrane lining the lungs, known as pleural mesothelioma. One that arises from the peritoneum is called the peritoneal mesothelioma and the one that arises from the pericardium is known as pericardial mesothelioma. Lastly, it can also arise from the tunica vaginalis known as testicular mesothelioma. People working with or prior exposure to asbestos are mostly at risk of developing mesothelioma. The latency period between time of exposure and development of mesothelioma can be somewhere between 20 to 40 years. Maximum of the patients who develop mesothelioma are men.
2. Gender: It affects the male populace predominantly. It is more common in men than in women and in those of lower economic status. However, the incidence of lung cancer, in women too, is on the rise of late.
3. Etiology: Cigarette/ Tobacco smoking remains the most important cause of lung cancer accounting for 85 – 90% of the cases. Incidence/ risk is proportionate to the number of cigarettes smoked irrespective of the age. Also, environmental toxins including smoke from burning black tar, exhaust gases from automobiles etc. too contribute actively to various lung diseases including cancer. People working in asbestos manufacturing factories who are exposed to asbestos dust are also likely to get lung cancer. Tuberculosis too is an additive risk factor. Again, people who have received ionizing radiation especially to treat Hodgkin Lymphoma or other malignancies also run the risk of developing lung cancer. Above-mentioned causes apart, genetic factors may also play a role.
4. Features: Lung cancer clinically presents in the following ways mainly.Signs & symptoms of malignant mesothelioma are as enumerated below
1. Difficult/ labored breathing (Dyspnea)
2. Chest pain
3. Palpable chest wall mass
4. Discordant chest wall expansion
5. Weight loss (Cachexia)
6. Loss of appetite (Anorexia)
7. Night sweats
Signs & symptoms of non-small cell lung cancer (NSCLC) are as enumerated below. Majority of patients are symptomatic at diagnosis
8. Chronic cough
9. Difficult/ labored breathing (Dyspnea)
10. Chest pain
11. Blood stained sputum (Hemoptysis)
13. Weight loss (Cachexia)
14. Loss of appetite (Anorexia)
16. Bone pain
17. Pleural or pericardial effusion
18. Superior vena cava syndrome
19. Brachial plexopathy
20. Neurologic pain
21. Hypercalcemia of malignancy
Signs & symptoms of small cell lung cancer (SCLC) are as enumerated below
Symptoms as per the points 8 – 18 depicted above for NSCLC are applicable for SCLC as well. Additionally, patients suffering from SCLC may have:
23. Horner syndrome
5. Screening: is generally recommended for asymptomatic/ symptomatic populations as surveillance for high risk individuals – who are either current or former smokers (quit smoking within the last 15 years), have at least a 30 pack year smoking history and those who do not have any prior history of lung cancer. The goal of screening, as usual, is to be able to detect & diagnose lung cancer at an early stage which is potentially curable. It is mostly radiologic with a low dose helical computed tomography (CT) scan being more effective in detecting early stage lung cancer than a chest radiograph can.
6. Diagnosis: Abnormal blood test results may be indicative of malignancy, but a follow up imaging/ biopsy is always the gold standard for accurate diagnosis. Following are the diagnostics employed mainly:
- Blood: Hb may be low, TLC, ESR and polymorphs increased. Adenocarcinomas are likely to express thyroid transcription factor 1 (TTF-1) or carcinoembyonic antigen (CEA). On the other hand, mesotheliomas are likely to express Wilms Tumor -1 (WT-1) protein and Calretinin.
- Imaging: Thoracoscopy, Bronchoscopy, X-Ray, CT Scan etc all. Positron Emission Tomography (PET) / CT scan and Magnetic Resonance Imaging (MRI) scan help detect metastasis, if any.
- Biopsy: It clinches the histologic diagnosis, and the nature of the disease.
7. Treatment: Conventional treatment includes surgery, chemotherapy and radiotherapy as contextually appropriate. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as would be feasible contextually.
8. Prognosis: preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage lung cancer are more. The cure/ recovery chances are influenced by the grade, stage of cancer, recurrence and the patient’s general health & vitality etc all. The primary determinant of prognosis in NSCLC is the stage at which the cancer is diagnosed. For non-metastatic cancers, however, it is the nodal status that determines the stage and hence the prognosis.
9. Prevention: rightly said, prevention is always a better choice. Cigarette smoking is to be avoided by all means as it is the single major cause of lung cancer. Even exposure to cigarette smoke (passive or secondhand) is also an established cause of lung cancer and is known to increase the risk of lung cancer in non-smokers as well. Preventing exposure to secondhand smoke can be helpful in decreasing the incidence and mortality from primary lung cancers. Above-mentioned apart, other important risk factors such as exposure to ionizing radiation, environmental carcinogens like smoke from burning black tar, exhaust gases from automobiles, outdoor air pollution, and occupational exposure to asbestos, arsenic, beryllium, nickel, cadmium, chromium etc all too are known to increase the risk for lung cancer and mortality thereof. In fact, cigarette smoking is known to potentiate the effect and hence the lung cancer risk of many of the above-mentioned carcinogens, multi-fold, in smokers. Thus, either eliminating or reducing the exposure to the above-mentioned carcinogens can lead to a decrease in the risk of lung cancer and incidences thereof. Furthermore, randomized clinical trials indicate that high intensity smokers (only) who take supplementation of beta-carotene have an increased risk/ incidence of lung cancer. Vitamin E supplementation, on the other hand, does not affect the risk of lung cancer as indicated by the trials. If you wish to discuss about any specific problem, you can consult a doctor.
I am suffering from dry cough for the last 2 Weeks and I have chest pain whenever I cough hard. Can you suggest what should be done.
What are the symptoms of asthma and give me medicine name so I purchase them and take for better health.
I am asthma patient from childhood. I am now 54 years old and now when I get an attack my heart feels as though it is having a spasm. Could this be the onset of a heart problem? What should I do?
My mother has pulmonary embolism and doctors prescribed acitrom 4 mg. She has hepatitis b. Also her haemoglobin level is 7. Can acitrom be given for an anemic patient .pls advise.
Hello sir 3 year back suddenly I got breathing problems. I went 2 Dr. He gives me nebulouser. He gives me some medication .He told me it's asthma witch happens when weather changes. Currently l am taking 1 tablet for BP daily. When ever I gets breathing problems I take Budamate200. Now I want you to suggest me according to reports wants kinds of precautions I should take like food, medicine extra extra Thanking you.
I have sinus problem from 6 months. What medicine I have to take. To which doctor I have to consult either I have to go with homeopathy or general physician.
Mujhe teen mahine pahle ek din subah balgam me khoon aaya tha aur gla chil gya tha khane pine me koi pareshani nahi hoti muh kholne par kan ko joint me dard mahsus hota tha maine Alchemist me Dr. Ko dikhaya unse hi dawai bhi le raha hu kan ke joint pain to thik ho gaya ek hafte bad par mujhe ab bhi ye lagta hai ki jaise gale me kuch atka huaa hai khasne ke bad bulgam aata hai ek dam gala saf ho jata hai 15 minut me fir aise hi hota hai or ajib se gandh aati hai jaise ki chasni ya ots ki khushubu din me kai bar aisa hota hai kabhi rat ko bhi jyada time par ye hota hai jaise dudh me jyda chini dalne par jo khusbu aati ha us trah ki or pet bhi badh gya hai pahle ke mukable aur resha bana rahta hai.
While spitting blood comes. For some time. 4 years back I was suffering from TB So please suggest. Is there any serious concerns.
What are the symptoms of spine Tb and can one contract spine Tb after a typhoid fever, how spine Tb is diagnosed what are the treatment options.
Sir, I am 21 year old and undergoing treatment for lymph node tuberculosis. At first the doctor told me that I have to take akt-4 for two months and akt-3 for four months but after seeing the tb pcr report he told me to take akt-4 for six months. I wanted to know whether this long duration of akt-4 medication can cause any serious side effects.
I am 24 year boy and have keratosis tonsil from 2 yrs. Please give suggestion how to control it or remove it mam. Can be he is danger for health.
I am suffering from dry cough for the last 2 weeks and I have chest pain whenever I cough hard can you suggest what should be done?
I want to get rid of cough. My nose has started paining because of sneezing Suggest any home remedy for the same.
The answer is unfortunately. Yes!
Meningitis, sometimes referred as spinal meningitis, is an inflammation of the membranes surrounding the brain and spinal cord. Usually caused by a viral infection, but it can also be caused by a bacterial or fungal infection.
Among pediatric patients admitted for treatment of sinusitis, 3.2% were found to have an intracranial complication. Infection of the sphenoid sinuses, however, merits concern. These thin-walled sinuses develop late in childhood, and their deep location places them adjacent to the dura mater and other critical structures.
Sphenoid sinusitis is identified in approximately 3% of cases of acute sinusitis, typically in the context of pansinusitis. Significant development of the sphenoid sinuses does not begin until age 4 to 6 years, thus, sphenoid sinusitis is restricted.
Viral infection causes most cases of spinal meningitis. Viral meningitis is usually mild and heals without treatment. Bacterial meningitis is more severe and requires treatment with antibiotics. Streptococcus pneumoniae and neisseria meningitidis are strains of bacteria that cause pneumococcus and meningococcus meningitis respectively.
It can be life threatening condition owing to its proximity to brain and spinal cord and infective media is the fluid surrounding them.
• Lumbur puncture – csf examination (cell count, glucose, proteins) and culture
• Blood culture
• Chest x ray
• CT scan of head and nose – pns
• MRI brain
Symptom checker in meningitis secondary to sinusitis:
• Fever (92%)
• Headache (85%)
• Nausea, vomiting (62%)
• Altered consciousness (31%)
• Seizure (31%)
• Hemiparesis (23%)
• Visual disturbance (23%)
• Meningismus (23%)
Conclusion and quick pearls:
• Complications that are less common with antibiotics
• Orbital (cellulitis, abscess)
• Intracranial (subdural empyema, thrombosis of cavernous sinus)
• Bony osteomyelitis.
• Can result in drastic sequelae
• Drain abscess and open involved sinuses
• Ent surgical involvement – functional endoscopic sinus surgery
- Usually amenable with medical treatment
- Drain sinuses if no improvement after 48 hours
• Ophthalmology check up
• Neurosurgery intervention
A low index of suspicion is necessary for early diagnosis and treatment of sphenoid sinusitis, orbital complications and prevention of intracranial complications including meningitis.