What is the cost of diagnosis, treatment for pulmonary diseases

Lung Complications + Rheumatoid Arthritis Increase Risk For Lung Cancer

(HealthDay News) — The risk for lung cancer is high in patients with rheumatoid arthritis (RA) and pulmonary complications, according to a study published online Sept. 3 in Modern Rheumatology.

Shunsuke Mori, M.D., Ph.D., from the Kumamoto Saishun Medical Center in Koshi, Japan, and colleagues assessed the incidence and predictive factors of lung cancer in people with RA. The analysis included 771 patients who were diagnosed with RA at a single institution between April 2001 and December 2022.

The researchers found that 3.5 percent of patients were diagnosed with combined pulmonary fibrosis and emphysema (CPFE), 4.9 percent with interstitial lung disease (ILD) alone, and 6.0 percent with emphysema alone. During a mean of 9.3 years, the crude incidence rates of lung cancer were 2.9, 47.8, 10.5, 11.9, and 0.8 per 1,000 patient-years in all patients, CPFE patients, ILD patients, emphysema patients, and patients without these complications, respectively. Compared with the general population, the standardized incidence ratios (95 percent confidence intervals) were 2.53 (1.29 to 3.77) for male patients and 0.89 (0.57 to 1.16) for female patients. The risk for lung cancer was found to be higher across conditions versus that seen in patients without complications (adjusted hazard ratios [95 percent confidence intervals], 13.48 [3.14 to 57.85] for CPFE, 6.42 [1.42 to 29.09] for ILD alone, and 4.65 [1.18 to 18.30] for emphysema alone).

"Close monitoring of lung cancer is needed for RA patients with smoking history and pulmonary complications, especially CPFE," the authors write.

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Navigating The Cancer Journey With Two Different Approaches

Two vastly different approaches to navigating the cancer journey may or may not be mutually exclusive.

From my lung cancer diagnosis in the summer of 2018 through treatment, remission and now a couple of years into survivorship, I have sought and appreciated a large caring support system. Early on in my treatment, I attended a support group at my church. At my initial visit, I went with a question in mind, in which several members of the group offered ideas and opinions that were helpful.

Since then, in many and varied ways, my peers have been there for me. And I, likewise, have been there for them. Since making progress in treatment, I have faithfully given of my time and resources to several relevant organizations and have felt hugely compensated in return. Then several years later, I learned of a close friend's very different choice of approaches to the cancer journey.

When diagnosed, both my friend's husband, the patient with cancer and I faced cancers which were life threatening.

My friend and her husband decided to focus on staying in the day and not getting ahead of themselves. They made sure not to overthink possible outcomes or side effects. On a day-to-day basis, they rarely discussed cancer with each other, much less with casual friends or neighbors. My friend's husband is now in remission.

Tumors were found on each of my two lungs in the Spring of 2018. Discovered as incidental findings on CT scans, then biopsied in late June, both tumors were tested and determined malignant. The first of my two surgeries took place in mid-July. The more concerning tumor, as well as lymph nodes in my chest, were removed and tested. I waited for what seemed like forever before getting the news: most of the lymph nodes were malignant. I had stage 3B non-small cell lung cancer.

I felt overwhelmed by the magnitude of the adversary I was facing, fighting the No. 1 killer of both men and women: lung cancer. As an introvert, with a supportive husband, three adult daughters and a few close friends, I feared they might not be enough. Although a person of faith since childhood, I had a hard time maintaining hope and confidence that God would pull me through. I prayed but struggled. Would God answer my prayers? I sensed I needed the prayers of as many caring and devout people as possible.

I went outside the box and let everyone that I knew know that my cancer was life threatening. I needed prayers from neighbors I knew only casually, parents of each of the students I tutored in my small business, even the checker in the supermarket. After my surgeon removed the tumor in my right lung, I had to face another significant fear.

I was terrified of receiving chemotherapy yet managed to complete my regimen. Soon after I had completed my chemo regimen, a kind woman from a local charity arrived at my front door one Saturday in mid-December 2018. She had called me a week earlier from Mrs. Claus Club and asked me if I would like to receive a gift basket of comforting items appropriate for patients with cancer. I said, "Of course," and upon arriving that weekend day, she brought me the basket and a beautiful, crocheted blanket as well. She shared with me that John, the leader of my church's support group, had given my name to her group.

From early in treatment, I had received many helpful messages from the American Lung Association (ALA), and as a result, I decided to make what, for me, was a large donation to the organization. A few days later, I received a call from the local office of the national organization. I was asked how I wanted my contribution to be used to benefit ALA. I chose the association's Lung Force Walk and eventually would lead a team, which I named Sue's Prayer Army, in ALA's primary fundraiser for Lung Cancer Activities.

St. Peregrine's Club, my church's cancer support group, named in honor of the Patron Saint of those suffering from cancer and other life-threatening diseases, did not meet for almost one-and-a-half years during the COVID-19 pandemic. The group had always met in person, and most members thought it should remain in person. That was especially unfortunate for me, because I had just reached remission and was longing for normalcy. I suffered from a PTSD-like emotional reaction, wishing I could return to my precancer life. Life from March 2000 through June 2021 turned out to be anything but normal.

Although after cancer is, for most of us, is not the same as before, I would gone on to find my new normal. Three of our group members I now consider friends one of them I call a best friend.

Then, while I was in remission in early 2023, I learned that two first cousins of mine, who each lived in different states than I, had recently been diagnosed with life-threatening cancers. I made contact with each of them after decades since last seeing either of them. I have been able to support both. I've felt rewarded with two renewed family connections. In June of this year, 10 members of my mother's side of my family were reunited in central Pennsylvania, two months after my cousin was deemed in remission.

I now consider him and his wife more new friends!

I celebrated reaching the five-year mark cancer free in June 2023, spoke that year at the Lung Force Walk, in appreciation of ALA and the years of joy and fulfillment I had experienced because of my involvement with the organization. It was also the fifth year of Sue's Prayer Army's participation. We raised our most ever, $3,500.

I feel so sure my life has been better because of the give and take of a community of individuals who have chosen to find the positive in the cancer journey, when it would be easier and more natural to be negative.

And yet, as I continued to read my friends message asking me to wait to hear from her and her husband, and to allow them to take the lead in any conversation, to let them live in the moment. I wondered about even more lifestyle choices during a cancer journey. While reading the note, I couldn't help but think about my meditation practice, which I'd started using early in the process of my diagnosis to increase calmness in my mind, body and soul. The approach my friend described made sense to me. In avoiding the inner dialog in one's mind, it would likely allow them to be free to experience less sadness and more joy, as well as making it more possible to talk and listen to God in prayer. Although all good things, my friend's plan left me feeling lonely.

Although, of course, I have honored their request, the social involvement of sharing my cancer journey has given me a powerful sense of belonging, a source of inspiration and stronger faith than I would have otherwise believed. I feel totally fulfilled by my private meditation practice as well.

I can't help but wonder whether these vastly different approaches to a trek through cancer treatment, remission and survivorship has to be mutually exclusive.

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Lung Cancer Symptoms: What You Must Know

Lung cancer often develops without showing any symptoms in its early stages. The lungs do not have many nerve endings, so a tumour can grow without causing noticeable pain. This makes it difficult for many people to detect lung cancer until it has advanced and spread to other parts of the body.

When lung cancer symptoms do appear, they may include:

• A chronic, raspy cough, sometimes with blood-streaked mucus

• Changes in a long-standing cough

• Recurring respiratory infections, like bronchitis or pneumonia

• Shortness of breath that worsens over time

• Wheezing, lasting chest pain, hoarseness, and trouble swallowing

• Shoulder pain

These symptoms typically occur when a tumour blocks airways or cancer spreads to nearby tissues.

Symptoms of early-stage lung cancer:

At Stage I, lung cancer is usually symptomless. It is often caught through screenings rather than the patient noticing symptoms. However, some signs may include a persistent new cough, coughing up blood or mucus, shortness of breath, chest pain, or frequent infections like bronchitis or pneumonia.

Symptoms of advanced lung cancer:

In Stage IV, when the cancer spreads to more areas of the lungs or other parts of the body, additional symptoms may develop, such as:

• Fatigue and weakness

• Loss of appetite and weight loss

• Headaches, numbness, or seizures if the cancer has reached the brain

Other uncommon symptoms:

Some symptoms of lung cancer affect parts of the body not directly connected to the lungs, such as:

• Clubbing of the fingers, where the nails curve and fingers appear larger

• High calcium levels in the blood, leading to stomach upset, thirst, frequent urination, or confusion

• Horner syndrome, which causes a drooping eyelid, a smaller pupil, and less sweating on one side of the face

• Swelling in the face, neck, or arms due to restricted blood flow

Skin-related symptoms

Lung cancer can also cause certain skin issues, such as jaundice (yellowing of the skin and eyes) or easy bruising due to interference with adrenal glands.

Lung cancer is the leading cause of cancer deaths globally, but the rates have been decreasing. However, the decline is not as significant among younger women. This has raised questions among experts, with genetic factors possibly playing a role. Historically, lung cancer has been associated with older men who smoke, so doctors may not immediately suspect the disease when a nonsmoking young woman presents with symptoms like a persistent cough or recurring respiratory infections.

Types of lung cancer and their symptoms:

There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC is more common, making up about 85% of cases. It has three subtypes:

1. Adenocarcinoma: More common in women and nonsmokers, usually found in the outer areas of the lungs.

2. Squamous cell carcinoma: Typically forms in the central part of the lungs near the airways.

3. Large cell carcinoma: Can develop anywhere in the lungs and tends to grow faster.

SCLC, while less common, spreads quickly and is more strongly linked to smoking. It is also more likely to cause symptoms like bone pain, confusion, seizures, and paralysis.

Both NSCLC and SCLC share many symptoms, such as coughing, chest pain, wheezing, and hoarseness. SCLC is more likely to cause hypercalcemia (high calcium levels) and problems with the adrenal glands.

When to see a doctor:

If you experience persistent coughing, coughing up blood, frequent respiratory infections, or wheezing, it is important to see a doctor. Additionally, sudden shortness of breath, coughing up large amounts of blood, chest pain that does not go away, sudden vision problems, or weakness should prompt an immediate visit to the emergency room.

Takeaways:

Lung cancer often goes unnoticed in its early stages due to the lack of symptoms. Common signs include a persistent cough, chest pain, and recurring infections. It is important to consult a doctor if you are concerned, as early detection improves the chances of successful treatment.

While lung cancer is a serious diagnosis, treatments are improving, and survival rates are increasing, particularly when the disease is caught early.

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