Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, February 21, 1995 TAG: 9502210044
SECTION: EXTRA PAGE: 1 EDITION: METRO
SOURCE: DR. CLAUDIA S. PLOTTEL ASSOCIATED PRESS
DATELINE: LENGTH: Medium
Cigarette smoking not only causes lung cancer, it also kills through illnesses such as emphysema, which affects more than 2.4 million Americans and kills an estimated 13,000 every year. Almost all cases are tied to smoking.
Emphysema is a chronic lung condition which progressively destroys the air sacs (alveoli) that permit lungs to transfer oxygen to the bloodstream and remove carbon dioxide. As emphysema worsens, lungs lose elasticity and the ability to expand and contract. Breathing grows more difficult. In advanced stages, emphysema may cause respiratory failure and affect heart function.
Emphysema develops after years of cigarette smoking and is usually diagnosed after age 50. Though it used to be a disease mostly of men, we now see it increasingly in women. Many women became smokers after World War II and have lived long enough to develop the disease.
Early symptoms include breathlessness with exertion (and later, even at rest); coughing, wheezing, and weight loss may or may not occur. But the trouble is that emphysema can start insidiously with no symptoms at all. Up to 50 percent to 75 percent of lung function may be lost before patients are aware of the problem.
Diagnosis requires a thorough medical history and physical examination. Tests to measure pulmonary function, such as airflow and lung volume, are performed as is a chest X-ray or CAT scan. A small number of people may have a genetic abnormality and develop emphysema even if they don't smoke. Blood tests can screen for that inherited abnormality.
Since destroyed lung tissue can't regenerate, treatment is directed at relieving symptoms, preventing further deterioration, and improving quality of life. It is mandatory to stop smoking. Various medications, either inhaled or in pill form, may be prescribed to ease breathing and enhance weakened patients' tolerance of daily activities, such as walking. Patients should receive a flu shot every fall and be considered for pneumococcal vaccine to protect against bacterial pneumonia.
Outpatient oxygen supplementation may be required in advanced stages. A mask or prongs in the nose attached to tubing connects to a portable oxygen supply that some patients can walk around with and use during sleep.
Lung transplantation may be an option for suitable candidates. Surgery to remove sections of damaged lung tissue is being attempted in some specialized centers in hopes of improving breathing in advanced cases.
The greatest gift smokers can give to themselves is to prevent emphysema in the first place. Though it isn't easy to quit smoking, millions have succeeded. For help, talk to a health care professional.
Claudia Plottel is a clinical assistant professor of medicine at New York University Medical Center.
by CNB