This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!) On episode 2 of season 8 (named “Transplant”), House treats the lungs of an 18-years old man who died in a motorcycle accident. The lungs were donated and planned to be transplanted in one of Wilson’s patients, but went bad just before the transplant, and House’s job was to find out what’s wrong with them. After ruling out cocaine abuse, a tumor in another organ (which affected the lungs) and even peanut allergy and heavy metal poisoning, House and his new and only team member find white blood cells in the lungs, and then diagnose the lungs with eosinophylic pneumonia

Photo by fox

Photo by FOX

Danger level: Medium

What is it?

Eosinophilic pneumonia is a group of diseases in which eosinophils (a type of white blood cells that are responsible for the body’s response in allergies and infections by parasites) accumulate in the lungs and interfere with their function.

Who gets it?

The disease isn’t common, but exactly how rare it is isn’t known. Different diseases in this group can be more common in men or women, and most of them develop in adults (usually not in elderly people).

What causes it?
Eosinophils are cells in our immune system that are active during allergic reactions and parasitic infections. When activated, eosinophils secrete chemicals that can cause inflammation. In people with eosinophilic pneumonia, eosinophils accumulate in the lung, are activated and secrete the chemicals – this causes the symptoms of the disease.
There are many causes for eosinophilic pneumonia. Some cases develop after the person is exposed to something outside the body – certain foods, drugs or even smoke (like in the House episode). Infections by parasites can also cause eosinophilic pneumonia. In other cases, the disease is related to changes inside the body – for example, it can be associated with another disease process. In some cases the reason for the disease is unknown.

An eosinophil, as seen under a microscope. Photo by Akay Miller

How does it feel?

The symptoms can be mild or severe, and include cough, wheezing and shortness of breath. When the disease is severe, it can cause the rate of oxygen in the blood to decrease and sometimes respiratory failure develops.

How is it discovered?

The doctor will suspect eosinophilic pneumonia if symptoms appeared shortly after exposure to foods or drugs that can cause the disease. Tests are performed to approve the diagnosis: blood tests to search for an elevated number of eosinophils in the blood; chest x-ray to see signs of pneumonia, and microscopic examination of lung secretions to search for eosinophils there as well.

How is it treated?

Usually, eosinophilic pneumonia is treated with steroids. If the disease appeared after exposure to foods or drugs – avoiding them will help with recovery, and if the disease is due to a parasitic infection – antibiotics are required.

What happens after treatment?

Most cases respond to medications (or even get better without treatment at all), but sometimes there’s severe lung failure which can be life threatening.

The bottom line – how do I avoid it?

If the disease appeared after exposure to a certain food or drug, avoiding them may prevent the disease from recurring. Also, people who had an attack of the disease should seek medical help right away if symptoms come back.

Related posts:

1. Your Questions Answered – Asbestosis – What Work Exposure Can Do To Your Lungs
2. Pleural Mesothelioma – Cancer of The Lungs Caused by Exposure to Asbestos
3. Deep Vein Thrombosis – Clots in Your Veins Which Can Travel To Your Heart and Lungs

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)
On episode 23 of season 7 (the season finale, named “Moving On”), Afsoun Hamidi, a performance artist, collapses during filming one of her projects. Later she has pancreatitis, something resembling a tumor in her brain, and a skin rash. Biopsy of the rash reveals that her symptoms are related to a condition called Wegener’s granulomatosis.

Photo by NBCUniversal

Danger level: High

What is it?

Wegener’s Granulomatosis (WG for short) is an inflammation of blood vessels, restricting blood flow to various organs in the body.

Who gets it?

WG is quite rare. In the United States, for example, it’s estimated that about 3 out of every 100,000 people are sick with it. It’s more common in people of Northern European origins, and is less common in black people. It can occur in any age, but is most common in middle age (the average age when it appears is around 40). Men and women are affected equally.

What causes it?

In WG there is an inflammation of blood vessels in the body, meaning it’s a vasculitis (the medical term for inflammation of blood vessels. There are other diseases in this group – such as temporal arteritis and kawasaki, which we covered before).

Our blood vessels generally come in 3 sizes, much like clothing. Small, medium and large. WG is an inflammation of small and medium sized blood vessels.

It happens because the body actually attacks its own blood vessels. The process isn’t completely understood, but probably involves a change in the body’s immune system which triggers the body destroying its own blood vessels.

WG tends to affect mostly 3 systems in the body: The upper airways, the kidney, and the lungs. They are affected since the arteries that supply them with blood are damaged in the disease.

How does it feel?

There are some general symptoms in WG which include loss of appetite, fever, fatigue, and even weight loss.

Usually the first specific symptoms involve the upper airways and can include nosebleeds, nasal congestion, collapse of the bridge of the nose (causing a deformity called saddle nose, seen in this picture), a hole in the nasal septum (which separates our right side of the nose from the left), inflammation of the sinuses (sinusitis), ear infections, difficulty breathing, and coughing (sometimes a bloody cough).

When the disease is in the lungs people may feel shortness of breath (which may be caused by bleeding in the lungs), or cough. When the kidneys are involved, kidney failure can occur, which may be life threatening.

Other organs may be involved, such as the skin (a rash may appear, like the one on House), the joints – which can become inflamed as well, and the nerves (something which can also affect vision – like the patient on House told that had happened to her).

Believe it or not, but there are even more possible symptoms, into which we won’t get here (including, rarely, pancreatitis, which for some reason was a main manifestation on House).

How is it discovered?

The disease resembles many other diseases, making the diagnosis difficult. A blood test checking for a component in the body called ANCA can be used, since it’s elevated in the disease. A physical exam, x-ray, and urine test, among others, can help with the diagnosis. The definitive way is performing a biopsy (taking a piece of an organ to look at under a microscope) on one of the involved organs, which will show something like this:

WG under a microscope. The round area on the left is called a granuloma, which is a mass of immune cells (that’s how the disease got its name). Photo by Nephron.

How is it treated?

Drugs that suppress the immune system (which attacks the body here) are used in WG. This includes steroids and chemotherapy.

What happens after treatment?

With treatment given on time, symptoms may disappear altogether. Still, in about half of patients, the disease may return. Before the disease was understood and the right treatments were given, about half of all patients died within 5 months. Today more than 75% get to live longer.

The bottom line – How do I avoid it?

Unfortunately, there is no known way to prevent WG.

Related posts:

1. Behçet’s Disease – Inflammation of Your Blood Vessels, Throughout the Body (As Seen on House MD)
2. Waldenström’s macroglobulinemia – A Rare Blood Cancer That Can Lead To Strokes
3. Peripheral Arterial Disease – A Narrowing of Blood Vessels that Will Shorten Your Life

On last night’s episode of Grey’s Anatomy, a cystic fibrosis (CF) patient named Ricky is about to undergo lung transplantation when it is found that he is in a relationship with another CF patient. They are forbidden to continue dating each other in order for him to be able to get the lung.

Why do CF patients have to keep away from one another? To understand that, first here’s a reminder about what cystic fibrosis is all about. As you can read in our article, CF is a genetic disease in which various organs in the body get damaged due to a genetic defect. An example of such an organ are the lungs. In CF, secretions in the airways are more thick, leading to their clogging. Germs multiply in the clogged airways, causing repeated infections.

Photo by Tanya Dawn

People with cystic fibrosis can pass on infections from one another easily, as both are more prone to infections than the general population. There are certain bacteria that are more common in CF patients than in other people. One of those is called Burkholderia cepacia, and another is pseudomonas aeruginosa. A person with CF can easily pass those on to another person with CF through close personal contact or by coughing near them. This is known as cross-infection.

The solution: Antibiotics. But, as more and more people with CF become infected with these bacteria, the bacteria may become resistant to antibiotic treatment.

Since people with CF are more likely to pick up strains from each other than from the environment, it is sadly recommended that people with CF do not come in close contact with each other. This includes no physical contact (like kissing, or perhaps even hand-shaking), no prolonged close contact (no playing together for young children, no long car rides together), no holiday parties for groups of CF families, etc.

Related posts:

1. Cystic Fibrosis – A Dangerous Inherited Disease Causing Thick Secretions
2. As Seen on Grey’s Anatomy – EX-Vivo Lung Transplant – A New Hope For Patients
3. As Seen on Grey’s Anatomy – Posttraumatic Stress Disorder – It Can Happen To Anyone

This is part of our House MD Project series.

Click here to read the connection to the episode (spoiler alert!)


On episode 18, called “Babies & Bathwater”, a young pregnant woman named Naomi is having brain and kidney dysfunction. An x-ray shows a mass in her lung, which turns out to be a type of lung cancer, called small cell lung cancer. The problems she had with her kidney and brain are related to a phenomenon called paraneoplastic syndrome, which often comes with that type of lung cancer.

Photo by Fox.

Danger level: High

What is it?

Lung cancer is a disease in which malignant cells form in the lung.

Who gets it?

Lung cancer is second most common cancer in the US, second only to prostate cancer in men and breast cancer in women. (Throughout the world it’s number 1 in men, and number 5 in women). It’s the leading cause of cancer death in the US.

Lung cancer is twice as common in men than in women. The chances of having it grow as you age.

People who smoke have the greatest risk of developing lung cancer (at least 4 out of 5 cases are associated with cigarette smoking). The risk of lung cancer increases with the number of cigarettes you smoke per day and the number of years you have smoked. About 10% of all smokers eventually develop lung cancer.

There are other risk factors related to developing lung cancer:

1. Exposure to secondhand smoke: Even if you don’t smoke yourself and only exposed to other people’s smoking your risk is higher.
2. Exposure to radon gas in the home: It hasn’t been completely proven, but some studies suggest there’s a relation between this and lung cancer.
3. Exposure to carcinogens: A carcinogen is a substance that’s involved in cancer formation. Examples include asbestos, radiation, arsenic, chromates, nickel, and others.

Smoking is the most proven risk factor for lung cancer. Photo by Helga Weber

What causes it?

The exact mechanism isn’t known. What is known is that there are several types of lung cancer, broadly divided into 2 categories: Small cell lung cancer (the one featured on the House episode) and Non-small cell lung cancer.

These names have been given because of the way the cancer looks under the microscope. But their separation means more than that: Small cell lung cancer is much more aggressive. It spreads quickly, making it particularly threatening. Up to 75% of people diagnosed with this type have a metastatic disease (cancer that has spread) by the time they are diagnosed.

Large cell lung cancer divides into further 3 types, but this is beyond the scope of this article.

How does it feel?

That depends on the type of lung cancer, where the cancer is, and the way it spreads.

One common symptom is a chronic cough. Some people cough up blood or sputum streaked with blood. Other things which may appear include loss of appetite, weight loss, fatigue, chest pain, and weakness.

Lung cancer can also cause all sorts of complications:

1. It can block the airways: This can lead to anything from wheezing, to a collapse of the lungs, to pneumonia.
2. It can cause a “pleural effusion” – that’s fluid that accumulates around your lungs.
3. It can cause something called Horner’s syndrome: Which is a condition in which you have a droopy eyelid, a small pupil, and reduced respiration on one side of the face. This can happen if the tumor hits a nerve on its surroundings.
4. It can cause paraneoplastic syndromes: This is the phenomenon shown on the House episode. These are things caused by the cancer at places far from the cancer itself
5. It can spread to other parts of the body through the bloodstream: areas it tends to spread to include the liver, brain, adrenal glands, spinal cord, or bones.

That’s a partial list. If not treated, it can also lead to death.

How is it discovered?

The first thing done is usually a chest X-ray. A CT scan will show the tumor with more detail, and also discover tumors that an X-ray may have missed.

A biopsy (a piece of the lung taken for examination under a microscope) is usually needed to confirm the diagnosis.

How is it treated?

There are various ways to treat lung cancers. They depend on the type of cancer, its location, its severity, whether it has spread, and the person’s overall health.

Treatments include surgery, chemotherapy and radiation therapy.

What happens after treatment?

Lung cancer isn’t good news, even when treated. On average, people with non-small cell cancer who aren’t treated survive 6 months. Treated, 70% of them may get well and live after 5 years. With small cell lung cancer, less than 1% will live after 5 years.

• Don’t smoke! Also, quitting smoking can lower your chances of developing lung cancer considerably.
• If you live or work with smokers, encourage them to quit and ask them not to smoke around you.
• If you’re exposed to cancer-causing chemicals at work, take necessary safety measures to limit inhalation.

Related posts:

1. As Seen on Grey’s Anatomy – EX-Vivo Lung Transplant – A New Hope For Patients
2. Blood Clotting Tendency (Thrombosis) – Are You at Risk? (As Seen on House MD)
3. Cell Phones Causing Cancer – What Is It All About? [News]

On yesterday’s episode of Grey’s Anatomy, a young patient who needed a lung transplant was also a lousy candidate for one, since he had too many risks. Instead of foregoing the whole thing, an ex-vivo lung transplant was performed on him instead.

Why does someone need a lung transplant, anyway?

There are some diseases that cause such damage to the lungs that a new lung is necessary. Such diseases include (don’t fret the confusing names – we will cover them at one time or another here on A Disease A Day) chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, cystic fibrosis, idiopathic pulmonary hypertension and others.

So why not give everyone the lungs they need?

There aren’t that many lungs that can be donated to begin with – only about 15-20% of donor lungs are acceptable for transplantation, since lungs are more susceptible to injuries than other donated organs (such as the heart).

Even when we have found a suitable lung for transplantation, not everyone waiting for a lung will get one. Each person waiting for a lung transplant has a score, based on the lung allocation score. For example, people who have a more immediate need for the lung come before those who can wait. Other factors, such as the illness the patient has, other diseases they have, etc. determine their score.

This means that many patients, like the one on the Grey’s Anatomy episode, are left far behind in the list, with a very low chance of ever getting a lung before dying.

What’s an ex-vivo transplant and how does it help things?

This technique was invented in 2008 by a team of lung transplant surgeons led by Dr. Shaf Keshavjee at Toronto General Hospital.

What it does is perfuse a special solution into an injured lung. It lets doctors “treat” the injured lungs while they are outside the body to make them suitable for transplantation. The technique can double the number of lungs fitting for donation.

How is it done?

After the donor lungs are removed from a deceased donor, they are transferred to a protective, transparent bubble-like chamber (like the one seen on the show). Then a series of steps is taken, in which the lungs are connected to a circuit composed of a pump, ventilator and filters through which oxygen, nutrients and a special solution are injected to the lung.

The bubble-like chamber with the lungs in it. Image courtesy of University Health Network

And on a final note – why is it called an ex-vivo transplantation?

Ex-vivo in Latin means “out of the living”. In this case, the healing process for the lungs occurs outside of a human body, inside this bubble-like chamber.

Here’s a video showing the repaired lung in action -

Related posts:

1. Can Cystic Fibrosis Patients Date Each Other? (As Seen on Grey’s Anatomy)
2. Lung Cancer – Why You May Be at Risk (As Seen on House MD)
3. As Seen on Grey’s Anatomy – IL-2 treatment, Anterograde Amnesia

Danger level: Medium

What is it?

Asthma is a disease which affects the airways, causing attacks in which breathing is difficult.

Who gets it?

In the Unites States, about 5-10% of the population (or 22 million people) are affected by asthma (6 million of them are children).

Around the world, asthma is more common in industrialized countries, such as Canada, England, Australia, Germany, and New Zealand. 2-10% (300 million) of people worldwide have asthma.

Until puberty, asthma is more common in boys than girls (twice as much). From then on there is no difference. About 2/3 of all asthma cases are discovered before age 18.

The following are considered risk factors, meaning they increase your risk of having asthma:

1. A family history of asthma – Asthma is partly genetic, meaning that if someone in your family has it, your chances of getting it are higher.

2. Frequent infections in your airways as a child

3. Living in an urban area, especially one that contains a lot of air pollution

What causes it?

Asthma causes an inflammation in our airways – these are the “tubes” that lead from our mouth to our lungs. This causes 3 things:

1. Airway obstruction – Our airways are surrounded by muscle. Normally, this muscle is relaxed, so air can move freely to our lungs and back out. In asthma, these muscles tighten and also produce a liquid called mucus. Those things cause the airways to get obstructed, so air can’t move freely.

2. Inflammation – Besides the attacks which cause momentary blocks in the airways, there is also an ongoing inflammation, which can cause long term damage to the airways if not treated.

3. Airway irritability – The airways in asthma patients are very sensitive to things healthy people usually don’t react to, such as pollen or dust. These things can bring about asthma attacks, which involve obstruction of the airways.

This video gives a graphic illustration of the process:

The following things are known to trigger asthma attacks in people with the disease (they change among different people):

a. Airborne materials, such as pollen, animal dander, mold, cockroaches and dust mites

b. Respiratory infections – Such as the common cold

c. Exercise

d. Cold air

e. Smoke

f. Certain medications – Such as aspirin, beta blockers and others.

g. Strong emotions and stress

How does it feel?

Asthma attacks include the following things:

1. Shortness of breath

2. Coughing

3. Wheezing – This is a whistling sound characteristic of asthma patients. It’s heard when you take the air out.

4. Chest tightness or pain

The severity of the disease is different for different people. In some people attacks may appear only after exercise, while in others they may come a few times a day, making their lives miserable.

This video shows someone with an attack who unfortunately ran out of medications and was waiting for an ambulance. Notice the coughing and the whistling sounds when he takes out air. (And please don’t try this at home…)

How is it discovered?

If someone comes to the doctor when they are having an attack, it can be pretty simple (as you can see in the video above) to know that they have asthma.

Unfortunately, by the time someone arrives at the doctor’s, the attacks are often gone. Besides, other diseases can have similar symptoms. Therefore these tests were invented which can discover asthma:

1. Pulmonary function tests – These are special tests done to test the patient’s breathing pattern when they breath into a machine. The pattern in asthma patients is pretty characteristic.

2. Challenge tests – Certain substances, when inhaled by people with asthma, can trigger an attack. Using these substances (such as one called metacholine) helps in diagnosing asthma.

3. Chest X-ray – Can be used to rule out other conditions (such as pneumonia).

How is it treated?

There are a few things which can be done to treat asthma:

1. Avoiding triggers

2. Medications – There are short-term drugs and long-term drugs. The short-term ones are used to control attacks. The long-term drugs are used to control the inflammation in the airways, which prevents long-term damage to them.

We won’t go into much detail about the types of drugs available, but some examples of long-term drugs include corticosteroids, beta agonists, and others.
Short-term drugs are drugs that are usually inhaled, and that cause dilatation of the constricted airways, thereby making it easier to breath. These drugs are taken through special inhalers, such as the one in the picture:

An asthma inhaler. Photo by net_efekt.

What happens after treatment?

Except in very difficult cases, these drugs help to live a normal life with asthma.

Also, about 50% of children diagnosed with asthma are asthma-free after 10 years (in adults the disease doesn’t tend to go away as much).

The bottom line – How do I avoid it?

You can’t avoid asthma altogether, since, as mentioned above, the disease is probably genetic.

What you can do is decrease your risk of having attacks, by following these rules:

1. Stick to your medications

2. Identify your triggers and avoid them – One way of doing this is to keep a diary in which you write down factors you encountered before attacks (such as cold air, a virus, cigarette smoke, etc.). Then take measures to minimize your exposure to these things.

3. Treat allergies – Asthma attacks can also be triggered by any allergies you may have. You should avoid or minimize contact with the substance you are allergic to.
Also consider allergy shots (consult your doctor about those).

4. Get a flu vaccine – Every year. The flu almost always makes asthma much worse.

On a final note, we try to give you a personal angle about diseases we cover here. This time, you can get it by visiting The Angry Asthma Mama blog and The Asthma Mom.

Related posts:

1. Heart Attacks and Women
2. Understanding Heart Attacks – Part 2 – Angina Pectoris
3. Cluster Headaches – Excruciating Attacks of Headaches

Back in April we covered the swine flu extensively here on A Disease A Day. With time, things didn’t seem as critical as they were in the beginning (even you said so in our poll).

Now things seem to take a new direction, as the disease is taking its toll worldwide. Here are the new facts:

1. According to the World Health Organization (WHO), 1 out of every 3 people in the world (or 2 billion people) will be infected with the disease over the next two years.
2. By the time you read this, 1,012 people have died as a result of the swine flu, according to the European Centre for Disease Prevention and Control (ECDC) in Stockholm.
3. In Europe, the disease has spread to 30 out of 31 countries in the European Union. In the UK, 30 people have died of the disease and the government has promised a supply of Tamiflu drugs sufficient for treating half the population in the British Isles (more than any other country). In Spain, 6 people have died so far. In France, the country’s strategy of treating swine flu victims in hospitals to curb the spread of the virus has been abandoned, acknowledging the disease had spread too far to be contained.
4. More from the UK: kindergarten teachers have been instructed to throw away soft toys, in order to spread growth of bacteria in them.
5. In the US more than a million people have been infected with the swine flu. Fortunately, their condition isn’t life threatening. Predictions are that these numbers will grow faster come Fall.
6. 3 cities in the US – Seattle, Chicago and New York City have the highest numbers of infected people.
7. A new study published this week claims that the virus can damage the developing brains of unborn offspring, meaning that pregnant women should stay as clear as they can of anyone known to be infected.

More masks in the near future? Photo by Guerry.

What does this all mean? No one knows for sure. One of the biggest fears is Winter, a problematic time for “regular” flu, which might turn as problematic for swine flu and raise the number of casualties even further.

Related posts:

1. China to Provide First Swine Flu Vaccines
2. The Swine Flu Poll – What’s Your Take?
3. In The News – Swine Flu (Influenza) – All You Wanted To Know

This is a guest post by PleuralMesothelioma.com, a medical information site with all of the latest on diagnosis and treatment of pleural mesothelioma.

Danger level: High

What is it?

Pleural mesothelioma is a type of cancer that develops in mesothelial cells (the cells which form the linings that surround and protect the lungs).

Who gets it?

Those who worked in industries that made common use of asbestos (a naturally occurring mineral) are at high risk for developing mesothelioma. Such occupations include shipyard workers, insulators, construction workers, welders, plumbers, electricians, steamfitters, pipefitters, boilermakers, railroad workers, chemical plant workers, power plant workers, miners and auto mechanics.

A shipyard. Workers of shipyards are at increased risk of developing mesothelioma. Photo by cunningba

The average age of a mesothelioma patient has historically been about 65 years old and men are 3 times more likely to develop the disease than women.

What causes it?

A vast amount of scientific and medical evidence has confirmed that malignant mesothelioma is caused by asbestos exposure. Presently, there is no other proven source for this disease. Asbestos is a naturally-occurring fibrous mineral that was widely used in industrial, commercial, and domestic products throughout the twentieth century. Asbestos was touted for its durability, fire resistance, and excellent insulating properties, and was used in several thousand different manufactured “asbestos products,” including construction materials, household appliances, and brake linings.

(We recently covered asbestosis, another disease caused by asbestos exposure).

How does it feel?

The initial symptoms of pleural mesothelioma are often similar to symptoms of other diseases that are much less serious (like influenza or pneumonia). Pleural mesothelioma symptoms include:

· Persistent dry or raspy cough (typically non-productive, meaning there is little or no phlegm)

· Coughing up blood

• Difficulty in swallowing
• Night sweats or fever
• Unexplained weight loss of 10 percent or more
• Fatigue
• Persistent pain in the chest or rib area, or painful breathing
• Shortness of breath that occurs even when at rest
• The appearance of lumps under the skin on the chest

How is it discovered?

Because this type of cancer has a long latency period (anywhere from 25 to 50 years after exposure to asbestos) and because the early symptoms are similar to that of less serious illnesses, pleural mesothelioma is rarely diagnosed in early stages. Unfortunately, like most cancers, mesothelioma is most treatable if diagnosed early.

Doctors use a few different types of diagnostic imaging scans and biopsy tests to identify mesothelioma. The most common type of imaging test used is a chest x-ray, but a doctor may also suggest a CT scan, PET scan or MRI scan.

A mesothelioma on a CT scan. You can see the large tumor on the left side of the picture (the other lung is black, meaning it’s tumor-free). Photo by Tdvorak.

Fluid and tissue biopsies are also a regular part of diagnosing mesothelioma. There are 4 main tests that are most commonly used:

• Fine Needle Aspiration: Mesothelioma cancers cause fluid to build up in affected locations, such as in the pleural membrane of the lungs (the lungs’ coverings). During a fine needle aspiration, a doctor will remove a fluid sample using a very long, thin and hollow needle.
• Thoracoscopy: Thoracoscopy is used in cases where pleural or pericardial mesothelioma is suspected. During this procedure a very small incision is made in the chest wall, through which a sample of tissue is removed.
• Bronchoscopy and Laparoscopy: These procedures are similar to the thoracoscopy, but are performed on different parts of the body. The bronchoscopy is used to view the trachea and airway, while the laparoscopy is used to remove samples of peritoneal tissue.
• Mediastinoscopy: This procedure is used to view lymph nodes in the chest and neck, to determine if cancer has spread from its point of origin.

How is it treated?

There are quite a few types of mesothelioma treatment offered, some recommended more often than others. The most frequently used treatments are surgery, chemotherapy, and radiation therapy. In addition, some experimental treatments are becoming more widely used, or are showing some encouraging results in clinical trials. These treatments include photodynamic therapy, gene therapy, and immunotherapy, among others.

Most of these treatments are not used in isolation. In many cases, treatment may consist of a combination of therapies. For example, surgery to remove as much of the cancer as possible may be followed by radiotherapy or chemotherapy to remove residual cancer cells. This is one of the most common treatment options for mesothelioma among those who are candidates for surgery.

What happens after treatment?

This again depends on what stage the cancer is in when it is diagnosed. Most often it is diagnosed after surgery is no longer an option and other options are very limited. After treatment is completed, doctors will assess the patient’s status with a number of tests to see if any of the cancer is left.

The only known way to avoid mesothelioma is to avoid exposure to asbestos. Asbestos is harmless if left undisturbed. But once damaged, microscopic asbestos fibers are released into the air where they can then be inhaled or ingested. The majority of homes built before 1980 contain asbestos insulation, so if you are ever remodeling be sure to take the proper precautions.

Related posts:

1. Your Questions Answered – Asbestosis – What Work Exposure Can Do To Your Lungs
2. Lung Cancer – Why You May Be at Risk (As Seen on House MD)
3. Four Dangers You’re Exposed to If You Live in an Old House

Recently we started asking you for your health questions. Today we’re inaugurating this column with the first question. You’re welcome to keep sending your questions through here or through Twitter (@diseaseaday).

L. from Malta asks:

“I was told that I have Asbestos in my lungs. I used to serve in the royal navy. I would like to know if there is any means of getting rid of this asbestos from my lungs?”

L.,

To answer your question, I’ll just present you with the facts about Asbestosis, in the same way we usually do here on A Disease A Day.

Danger level: Medium

What is it?

Asbestosis is a lung disease caused by inhalation of asbestos fibers.

Who gets it?

The disease usually occurs in people with long exposure to asbestos (a fibrous mineral). This can occur in the following occupations: Plumbers, pipefitters, steamfitters, electricians, insulation workers, carpenters, laborers, boilermakers, welders and cutters, and janitors. Asbestos exposure is also seen in people working in some industries, such as construction, shipbuilding and repairing, chemicals and other manufacturing, railways, trucking, and plastic and rubber manufacturing.

You don’t have to actually work with the material to get asbestosis – people who work alongside the workers in a shipyard may get it too (which might explain L.’s exposure) and also there have been cases of wives of people exposed to asbestos getting exposed themselves through washing their husbands’ work clothes.

Today asbestos is used less (it was replaced with synthetic mineral fibers, such as fiberglass) but it’s still used in the developing world.

Usually it takes at least 10 years of exposure before the disease can manifest.

Asbestos. This mineral is made of fibers, which can be inhaled and cause damage to the lungs.

What causes it?

The asbestos fibers, when inhaled, can do one of 2 things to the lungs:

1. They have a toxic effect on the cells of the lung
2. They cause inflammation in the lung

It’s important to mention that smoking makes this worse, since it damages the body’s ability to get rid of the asbestos fibers.

As a result of the inflammation in the lung, the lung undergoes fibrosis (or scarring) – This means that its normal tissue, which enables us to breath, changes gradually to a connective tissue, that lacks the normal characteristics of the lung.

How does it feel?

This article deals with asbestosis, but it’s important to know that 2 other things can be caused by asbestos exposure as well –

1. Disease in the lung’s coverings
2. Lung cancer

In asbestosis, people who were exposed to the fibers are usually fine for 20-30 years after the first exposure (but the more fibers they were exposed to, the less time it will take for the disease to show). Then the following things can happen -

1. Shortness of breath – They will feel this when they make physical efforts. That’s because the lung can’t provide as much oxygen as it could if it were healthy. The shortness of breath tends to progress in severity with time, even without further exposure to the fibers.
2. Inspiratory crackles – These are coarse sounds the doctor can hear when they put the stethoscope on the chest to listen to the lungs.
3. Clubbing – Clubbing is raising of the fingernails. It can happen in other diseases as well.

An example of clubbing in the fingers.

With severe cases, heart failure can also occur.

How is it discovered?

There are 3 things that can help in diagnosing asbestosis:

1. A story of exposure to asbestos
2. Chest X-rays or CT scans that show the fibrosis in the lungs
3. Pulmonary function tests – These are tests that check the function of the lungs and will show that they don’t work efficiently.

How is it treated?

There is no cure for asbestosis. Stopping the exposure to asbestos will help, but the disease can progress even after the exposure is stopped. The following things can help -

1. Oxygen may be given to ease the shortness of breath.
2. Stopping smoking – It can help, since smoking makes the disease worse.
3. Treatment on time of respiratory infections – Since they tend to complicate more in people with lung problems. Also vaccines should be given when possible.

What happens after treatment?

That depends on many things, such as the duration and the extent of exposure to asbestos. Some people will have a milder disease than others.

The bottom line – How do I avoid it?

The best way to prevent asbestosis is to minimize exposure to asbestos. In the United States, by law, a worker’s exposure to asbestos may not exceed 0.1 fiber per cubic centimeter of air. Federal law requires employers in industries that work with asbestos products (such as construction and shipyard industries) to monitor exposure levels, create regulated areas for asbestos work, and provide their employees with appropriate training, protective gear such as face masks, and decontamination hygiene areas.

This movie, from 1959, created by the Bureau of Mines of the US talks about the “wonders” of asbestos. Since then, of course, its use has gone down.

For further reading you can visit this AsbestosHUB, which provides updated information about asbestos and asbestos-related diseases.

Related posts:

1. Pleural Mesothelioma – Cancer of The Lungs Caused by Exposure to Asbestos
2. Eosinophilic Pneumonitis – When The Lungs Are Sensitive. Very Sensitive. (As Seen On House MD)
3. Four Dangers You’re Exposed to If You Live in an Old House

The World Health Organization  has declared that swine influenza is “a public health emergency of international concern”. We are here to help you understand about the disease.

update: Since the news about the disease is spreading even faster than it does, you can stay up-to-date by following us on Twitter.

Danger level: High

What is it?

Swine influenza (or swine flu) is a respiratory disease of pigs.

Who gets it?

Normally, swine flu doesn’t infect humans. From December 2005 through February 2009, only 12 people were reported to be infected with swine flu. In most of these cases, these people had direct exposure to pigs. Since March 2009, though, the virus started spreading in humans in San Diego County and Imperial County, California, as well as in San Antonio, Texas and in Mexico. The total number of cases in the US alone in this month was 11 (the same number of humans infected in 4 years).

At the moment, no age, sex or race are known to be related to infection with the swine flu. It is known however, that since it’s spread from person to person through the air, people in contact with those who have gotten the disease are more likely to get it themselves.

What causes it?

To understand swine flu, it’s important to first understand about the influenza virus. Viruses, just like germs, are “bugs” that can spread diseases. Unlike germs, viruses are so small that they can’t be seen under a microscope. Also unlike germs, viruses don’t respond to antibiotics.

The influenza virus has 3 types. One of those is influenza A. This type causes the most severe disease in humans. It usually grows in birds, but can be transferred to other animals/humans and cause outbreaks.

Influenza Virus (from very up-close).

Influenza A has some types of its own, since it has two components on it, one called H and the other called N.

We all know that influenza occurs every year, and even people who were vaccinated against it can get it the next year. Why? Because the virus is “smart” – it can undergo changes in its structure. That’s why new types of vaccines are produced every year.

Once in a while, though, the changes are so big, that even the H and N components in it change. The vaccines can’t handle such changes. Such a change happened in 1918. It was called the Spanish flu and was caused by influenza A whose H and N components were called H1N1. It spread throughout the world and killed between 20-100 million people, since no cure was known then.

The new swine flu also belongs to the H1N1 subtype of influenza A, and contains a combination of genes from swine, birds and human flu viruses.

How does it feel?

The symptoms of swine flu are no different than those of the “regular” human flu. They contain:

1. Fever and chills
2. Body aches
3. Headache
4. Weakness
5. Cough
6. Lack of appetite
7. Other things that can happen include a sore throat, nausea, vomiting and diarrhea.

Swine flu can also lead to pneumonia and to a respiratory failure, which can lead to death.

How is it discovered?

To discover if you have the swine flu, a sample from your airways can be taken. It is then sent to the Center for Disease Control and Prevention (CDC) for lab testing.

How is it treated?

There are 4 types of drugs that can treat influenza: amantadine, rimantadine, oseltamivir and zanamivir. The new swine flue is resistant to amantadine and rimantadine, leaving the latter two as treatment options.

What happens after treatment?

Unfortunately, not much is known at the moment. The CDC believes that the drugs mentioned above can cure and prevent the disease.

There is no vaccine at the moment that can protect you from the swine flu. There are steps you can take to lower your chance of getting it or of passing it to others -

1. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
2. Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
3. Try to avoid close contact with sick people.
4. If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them. Avoid touching your eyes, nose or mouth. Germs spread this way.

The following video from the CDC sums it up -

You can use the comments below to discuss any of your fears or personal experiences with the swine flu.

Related posts:

1. The Swine Flu Poll – What’s Your Take?
2. China to Provide First Swine Flu Vaccines
3. Swine Flu – 7 New Facts