latent tb and lung cancer :: Article CreatorLung Problems And HIV
Key points
Some lung problems can be more serious in people with HIV and occur more frequently. Smoking is a very common cause of lung disease. Antibiotics can be used to treat and prevent bacterial lung infections. Regular exercise can improve the efficiency of your lungs. The lungs are organs found in the chest, either side of the heart, protected by the ribcage. The right lung tends to be larger than the left lung. The lungs are covered with a thin layer, or membrane, called the pleura, and the rib cage with another membrane. The two membranes slide over each other as we breathe allowing the lungs to expand and contract.
Inside, the lungs look like sponges and are made up of a mass of fine tubes. The smallest of these tubes are air sacs called alveoli, the walls of which are covered in tiny blood vessels.
The lungs and breathing
The role of the lungs is to absorb oxygen from the air and transfer it to the blood where it is then circulated around the body.
Each time you breath in, air is transported down the nose or throat into the windpipe (trachea) and into two smaller tubes called bronchi; one going to the left lung, the other to the right. The air is then divided into smaller airways called bronchioles until it reaches the alveoli. Inside the alveoli, oxygen moves into the tiny blood vessels forming the walls and is picked up by red blood cells ready to be transported around the body. At the same time, waste products in the form of carbon dioxide move in the opposite direction; travelling from the blood into the alveoli and onward through the lungs to be breathed out.
Lung disease
Symptoms such as coughing, shortness of breath, coughing up blood, phlegm or mucus, and pain in the lungs are all signs of a problem in the lungs.
As with anybody else, people with HIV can contract colds or influenza (flu), which can affect the chest, causing symptoms such as a cough, and the production of phlegm. These normally clear up in a few days and cause no lasting damage. There are, however, some lung problems which are seen more often in people with HIV which can be very serious.
Although anybody can become ill with bacterial pneumonia, pleurisy (inflammation of the membrane surrounding the lungs), and bronchitis, these can be more serious in people with HIV and occur with more frequency, particularly if they have a depressed immune system.
Pneumonia due to pneumocystis (PCP) affects the lungs and is normally seen only in people with a CD4 count below 200. It is rare in countries where people have access to modern medical care. The cancers Kaposi's sarcoma and non-Hodgkin's lymphoma, which are more common in people with very low CD4 counts, can also affect the lungs.
"Taking HIV treatment can prevent your immune system becoming so weak that you develop serious lung infections."
Tuberculosis (TB) is seen in increased rates amongst people with HIV and globally, it is the leading causes of illness and death amongst people with HIV. TB can develop at any time during HIV infection. People with weakened immune systems are more vulnerable to infection with TB. TB can be treated and cured.
Smoking is a very common cause of lung-related problems and is the main cause of lung cancer.
Lung cancer is more common in HIV-positive people than in the general HIV-negative population.
Smoking is also the leading cause of chronic obstructive pulmonary disease (COPD), a group of lung diseases which cause breathing difficulties. Studies have shown that people with HIV are at an increased risk of COPD, whether or not they smoke. However, smokers are much more likely to report symptoms of COPD. One study found that smoking has a greater impact on COPD in people living with HIV than in HIV-negative people.
Tests
If you have any kind of breathing problem, your doctor will listen to your chest with a stethoscope to assess how well your lungs are working.
Glossary tuberculosis (TB)
A disease caused by the bacterium Mycobacterium tuberculosis. There are two forms of TB: latent TB infection and TB disease (active TB). In people with HIV, TB is considered an AIDS-defining condition.
chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include difficulty breathing, cough, mucus (sputum) production and wheezing. It is caused by long-term exposure to irritating gases or particulate matter, most often from tobacco smoking (active or passive).
immune system
The body's mechanisms for fighting infections and eradicating dysfunctional cells.
symptom
Any perceptible, subjective change in the body or its functions that signals the presence of a disease or condition, as reported by the patient.
pneumonia
Any lung infection that causes inflammation. The infecting organism may be bacteria (such as Streptococcus pneumoniae), a virus (such as influenza), a fungus (such as Pneumocystis pneumonia or PCP) or something else. The disease is sometimes characterised by where the infection was acquired: in the community, in hospital or in a nursing home.
Other common tests to check for infection or disorders include chest X-rays and, sometimes, an induced sputum test, where a mist of salty water is inhaled in order to 'induce' the patient to cough up sputum from the lungs. A bronchoscopy may also be used, where a small camera is passed down the nose, and a transbronchial biopsy involves taking small samples of lung tissue for checking. Alternatively, a small piece of pleura may be removed via the chest wall; a pleural biopsy. Lung-function tests, which measure the ability to transfer oxygen and how well the lungs inflate, may also be used. A body scan may be used to look for some infections or cancers.
Treatments
Antibiotics can be used to treat and prevent bacterial lung infections such as pneumonia, and can also be successfully used to treat PCP and TB. Taking HIV treatment can prevent your immune system becoming so weak that you develop serious lung infections.
Chemotherapy, radiotherapy and surgery are used to treat cancers in the lungs.
Keeping your lungs healthy
Smoking is responsible for a lot of lung disease so stopping smoking will improve the health of your lungs. Taking regular exercise which makes you out of breath improves your lungs' efficiency. Ensuring that you receive regular check-ups at your HIV clinic will mean that you are monitored and treated for any possible HIV-related lung problems. Taking HIV treatment will keep your immune system strong. And eating a diet rich in fresh fruit and vegetables will help promote your general health.
Early Signs And Symptoms Of Lung Cancer
Most people do not experience lung cancer symptoms during early stages but may notice signs if it spreads. Potential symptoms include unexplained weight loss, general fatigue, and difficulty breathing.
Some people experience subtle symptoms of early-stage lung cancer, but these symptoms more often stem from other health issues or factors such as smoking.
Lung cancer treatment is more effective during the early stages, so it is important for people to identify symptoms and seek a diagnosis as soon as possible.
This article explains some potential early symptoms of lung cancer, risk factors, and when to see a doctor.
According to the American Cancer Society (ACS), most types of lung cancer do not cause symptoms until they spread to other areas. However, some people may experience subtle symptoms during the earlier stages of the disease.
The symptoms below usually result from another underlying cause. However, people with these symptoms should visit their doctors as a precautionary measure.
Sudden weight loss
Unexplained weight loss is a common lung cancer symptom.
A 2018 study of 3,180 adults with lung or gastrointestinal cancer found that 34.1% of the participants had already experienced weight loss by the time of diagnosis. The authors also associated weight loss before cancer treatment with lower survival rates.
Cancer can cause weight loss for many reasons, including:
Shortness of breath
Shortness of breath and wheezing are both common symptoms of lung cancer.
Some people may experience a slight cough in addition to shortness of breath. Others may have difficulty catching their breath but no cough.
Cough
A cough that does not go away after three weeks can indicate lung cancer. Some people may assume this cough is due to smoking.
The level of coughing may not always align with cancer progression. The authors of a 2018 study did not associate smoking or lung cancer stage with the severity of coughing.
A cough that produces blood may result from lung cancer or another issue with the lungs. Anyone with this symptom should see a doctor.
General fatigue
Fatigue is one of the most common symptoms of lung cancer. Lung cancer fatigue may be due to:
tumor development anemia — a lack of red blood cells to carry oxygen difficulty sleeping due to the disease pain malnutrition Severe fatigue may make daily functioning harder.
Shoulder, chest, or back pain
Most people with lung cancer do not feel pain during the early stages because there are very few nerve endings in the lungs.
However, pain can occur when lung cancer invades the chest wall, ribs, vertebrae, or certain nerves. For example, Pancoast tumors, which form at the very top of the lungs, often invade nearby tissues, causing shoulder pain.
As a tumor develops, a person may begin to feel pain in their:
Coughing or laughing may worsen chest pain.
Hoarse voice
A person with lung cancer or another respiratory disease may develop a hoarse, raspy voice.
This can happen if a tumor presses on the laryngeal nerve within the chest. When something compresses the nerve, it can paralyze a vocal cord, causing the voice to change.
Finger clubbing
A less typical symptom of lung cancer is finger clubbing. This causes the following changes to fingers and toes:
more pronounced curves larger, rounded fingertips curved fingernails While lung cancer is a main cause of finger clubbing, the condition occurs in only 5% to 15% of people with lung cancer.
It is not entirely clear why finger clubbing occurs. It may be due to reduced blood oxygen levels causing tissue changes.
Horner syndrome
Pancoast tumors in the upper lungs can also cause a condition called Horner syndrome. This occurs when the tumors affect nerves that lead to the eyes or face.
Symptoms of Horner syndrome will occur in one eye or on one side of the face and may include:
If lung cancer spreads, it may cause other eye problems, including blurriness, pain, and vision loss.
Hypercalcemia
Hypercalcemia occurs when there are high levels of calcium in the blood. It may be due to tumors releasing hormones that affect bone formation and calcium absorption.
Since hypercalcemia affects the entire body and can be due to other conditions, doctors may not recognize it as a lung cancer symptom initially.
Signs of hypercalcemia can include:
According to the Centers for Disease Control and Prevention (CDC), cigarette smoking is the biggest risk factor for lung cancer, accounting for 80% to 90% of lung cancer-related deaths.
When describing risk, organizations and experts may use the term "pack-year." A pack-year is the number of cigarettes a person smokes per day each year. For example, a person with a 30-pack-year smoking history may have:
smoked one pack per day for 30 years smoked two packs per day for 15 years Other risk factors for lung cancer include:
using other tobacco products, such as cigars or pipe tobacco inhaling secondhand smoke exposure to radon gas working with dangerous chemicals, such as: living somewhere with high pollution having other lung conditions, such as chronic obstructive pulmonary disease having a family history of lung cancer Screening
The U.S. Preventive Services Task Force recommends yearly lung cancer screenings for people ages 50 to 80 years who:
currently smoke or have quit smoking in the past 15 years have at least a 20-pack-year smoking history are aware of the potential benefits and harms of screening can visit a facility that has experience with lung cancer screening and treatment Screening cannot detect every instance of lung cancer, but it may lower a person's risk of dying from the disease.
According to the CDC, people who smoke have a 15 to 30 times higher chance of dying from lung cancer than people who do not smoke.
They also highlight that, from 2013 to 2014, 1 in 4 people who did not smoke, including children, were exposed to secondhand smoke. This increases their risk of developing the disease.
Quitting smoking can reduce the risk of lung cancer regardless of age.
The symptoms above usually result from issues other than lung cancer. However, since they can indicate cancer, anyone who experiences the following issues should visit a doctor:
Often, there are no symptoms during the early stages of lung cancer.
Below are answers to some common questions about the early stages of lung cancer.
What is usually the first symptom of lung cancer?
Lung cancer usually does not show signs at first. Symptoms are most likely to appear after the cancer has spread.
Initial symptoms may include a persistent cough, chest pain, and unexplained weight loss. Lung cancer screenings may detect the disease even without symptoms.
Can someone test themselves for lung cancer?
Medical tests are necessary to find and confirm lung cancer.
Doctors may use low dose CT scans or other imaging tests to look for abnormalities in the lungs. They will confirm the diagnosis by looking at lung cells under a microscope.
Where does lung cancer usually start?
Lung cancer often starts in the alveoli (small air sacs in the lungs) or the cells inside the bronchi, the tubes that branch off from the windpipe to enter the lungs.
Other cancers may spread to the lungs from other areas of the body, but those are not lung cancer.
When do lung cancer symptoms appear?
Lung cancer symptoms typically appear after the cancer spreads. Symptoms may worsen as the disease progresses, and new symptoms, such as lymph node swelling and bone pain, may develop if the cancer moves to other parts of the body.
Lung cancer does not usually cause symptoms until it spreads. This can cause a delay in diagnosis and treatment.
However, some people experience subtle symptoms during the initial stages. Recognizing these is important because treatment is typically more effective at this stage.
Anyone with potential symptoms of lung cancer should see a doctor. In many cases, another health condition is the cause, but it is best to seek medical advice as a precaution.
Read this article in Spanish.
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