Breathe Easy

By Rod Evans

Houston Methodist Lung Associates at San Jacinto provides world-class care for lung disorders

Conditions impacting the lungs that make it difficult to breathe affect millions of Americans. Whether it’s asthma, chronic obstructive pulmonary disease (COPD) or even lung cancer, countless people suffer each day with the simple act of breathing; something many of us take for granted.

Houston Methodist Lung Associates at San Jacinto provides expertise in the diagnosis and treatment of the full spectrum of lung diseases and breathing and respiratory disorders. The center’s care team includes pulmonologists, thoracic surgeons, oncologists, radiologists, pathologists and respiratory therapists who provide care in an outpatient setting. These skilled specialists diagnose and treat a wide range of conditions, including pulmonary hypertension, COPD, asthma, central airway obstruction and lung cancer.

Advanced Lung Cancer Diagnosis and Treatment

Lung cancer is the leading cause of cancer death among men and women in the U.S., with the disease claiming the lives of an estimated 158,000 people per year. More men are diagnosed with lung cancer than women, and African-Americans—especially men—are at a higher risk of lung cancer than any other ethnic group.

“Early detection is one of the keys to successful treatment. In the past, most patients didn’t realize they had lung cancer until it had reached an advanced stage,” said thoracic surgeon Dr. Shawn Tittle, medical director of the Houston Methodist Cancer Center at San Jacinto, “but screening with low-dose radiation CT scanning allows us to detect lung cancer long before it becomes symptomatic or spreads outside the lungs.”

The Lung Cancer Screening Program at Houston Methodist San Jacinto Hospital is designated by the American College of Radiology (ACR) as a Lung Cancer Alliance Screening Center of Excellence. The center provides screening for people 55 to 77 years of age who currently smoke or have quit smoking in the past 15 years, have a tobacco smoking history of at least 30 “pack years” (an average of one pack a day for 30 years, two packs a day for 15 years, etc.), and receive a written order from a physician.

One of the most persistent misconceptions about lung cancer, especially among long-term smokers, is that it is “too late” to stop. But Tittle says that quitting smoking at any time not only can reduce the risk of cancer, but also provides other health benefits, including improved circulation and heart and lung function.
“A smoker can cut his or her risk of lung cancer by as much as 50 percent by quitting,” Tittle said.
While smoking is the No. 1 cause, approximately 20 percent of lung cancers occur in patients who have never smoked. Genetic mutations, environmental factors, such as exposure to asbestos or radon gas are among the other possible factors.

Proven Expertise in Managing COPD

More than 11 million Americans have been diagnosed with COPD, but according to the American Lung Association, an estimated 24 million people may have the disease without even realizing it, choosing to ignore the coughing and shortness of breath that are the hallmarks of the disease until significant damage has been done.

“Sometimes it’s challenging to make a diagnosis early in the course of the disease, as the patient is less likely to report symptoms because symptoms have developed over a long period of time and they have gotten used to them,” said Kalil Al-Nassir, MD, FACP, a pulmonologist at Houston Methodist Lung Associates at San Jacinto. “When someone comes in and says, ‘I am out of breath and can’t do anything,’ they may have lost about half of their lung function by then.”

COPD, the third leading cause of death in the U.S., encompasses mainly two conditions: emphysema and chronic bronchitis. Al-Nassir said most COPD patients have some combination of emphysema and bronchitis. The disease is most commonly caused by tobacco smoking, although prolonged exposure to second hand tobacco smoke, hazardous industrial fumes and air pollution may play a role.

COPD may be diagnosed through a three-part exam called a pulmonary function test, in addition to CT scans and chest X-rays. Al-Nassir said treatment generally consists of the use of inhaled medications such as bronchodilators. There is no cure for COPD, but Al-Nassir says pulmonologists work to improve the patient’s quality of life and reduce the occurrence of flare ups.

In addition to inhaled medications, the best way to prevent flare ups is to quit smoking. Other preventive recommendations include regular hand washing, using oxygen supplementation when prescribed, and getting pneumonia and flu vaccinations.

Comprehensive Asthma Care

Asthma causes the airways—the tubes that carry air in and out of the lungs—to become inflamed and narrowed. During an asthma flare-up or attack, the airways become even more swollen and the muscles around the airways can tighten. This often triggers wheezing, coughing, tightness in the chest and shortness of breath. The Asthma and Allergy Foundation of America estimates over 25 million Americans suffer from the disease.

Al-Nassir said becoming familiar with the possible causes of asthma attacks and reducing exposure to those triggers can help patients minimize their risk of potentially dangerous symptoms.

“Asthma can’t be cured, but it can be managed so you can live a normal, healthy life. A comprehensive approach to managing asthma is required because it’s a complex, chronic disease and it’s different for every person,” Al-Nassir said.

Common asthma triggers include air pollution; allergens; certain medications, including aspirin and ibuprofen; exercise; smoke from cigarettes, fireplaces and campfires; and weather conditions

Most people with asthma need two kinds of medication: quick-relief medicines to stop asthma symptoms and long-term control medicines to prevent symptoms. Maintaining a healthy lifestyle is also vital. Proper rest, diet and exercise are not only good for your overall health, but also can help you manage your asthma.

Sleep Apnea Solutions

Sleep apnea—a chronic condition caused by a blockage of the airway and requires long-term management that may include lifestyle changes, breathing devices and, possibly, surgery—affects an estimated 18 million Americans. Left untreated, Al-Nassir says sleep apnea can result in serious health consequences, including increased risk of high blood pressure, heart attack, stroke, obesity and diabetes.

“Pauses in your breathing while sleeping may last up to a few minutes and can happen as often as 30 times per hour in severe cases, causing you to move out of deep sleep,” Al-Nassir said. “Without some solid hours of deep sleep each night, you may find yourself nodding off at your desk during the day.”

Snoring is the most common symptom of sleep apnea, which is most prevalent in people over 40. If you’re feeling irritable or depressed, or find yourself waking up in the morning with a headache and dry mouth, it may be time to talk to your doctor about scheduling a sleep study. The Sleep Center at Houston Methodist San Jacinto Hospital is accredited by the American Academy of Sleep Medicine (AASM) and conducts thorough sleep studies, including home studies.

For more information on services offered by Houston Methodist Lung Associates at San Jacinto and to schedule a consultation, call 281.428.4510.