Dr. Howard Michael Katz, MD

For visualization, bronchoscopy can be done alone, or it can be combined with ultrasound. Endobronchial ultrasound (EBUS) allows real-time imaging of the airway and is used for diagnosing and staging lung cancer, as well as for determining where the cancer has spread. EBUS can be performed with TBNA, a procedure known as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).

Doctors can also use bronchoscopy as a treatment for lung problems. For example, if a foreign body is trapped in the airway, doctors can insert forceps through the bronchoscope to remove it. If the airway has become narrowed - which may occur if patients have an infection, cancer, or some other inflammatory issue - bronchoscopy can be used to place a device called a stent in the area of constriction. The stent will keep the airway open, allowing the patient to breathe properly.

During a bronchoscopy, patients will be given medication (sedative) to help them relax. If it is only a diagnostic bronchoscopy, patients will be kept awake, but if the bronchoscopy is for therapeutic purposes, patients will be put to sleep by general anesthesia. After the procedure, patients will need to stay in the hospital for a few hours. They will not be able to eat or drink for about 2 hours. Some patients may experience discomfort, such as a sore throat or pain while swallowing. Throat lozenges and gargling may help alleviate these symptoms, which should go away after a few days. Patients will need to have someone drive them home once their doctor determines that they are ready.

Asthma is a chronic disease where swollen, inflamed airways make it hard to breathe. It is often brought on by specific triggers. While asthma is a common condition, affecting millions of people, it can also be serious and even fatal in severe cases. Treatment involves avoiding triggers and using inhaled corticosteroid medications.

COPD, or Chronic Obstructive Pulmonary Disease, is the name given to two illnesses that both cause difficulty breathing: emphysema and chronic bronchitis. In emphysema, the air sacs of the lungs become damaged, while with bronchitis they become clogged with mucus. COPD is the fourth leading cause of death in the United States. It is almost always caused by breathing irritants into the lungs, such as smoking or heavy pollution.

Pneumonia is a lung infection that can be caused by bacteria, a virus, or fungi. Most healthy people recover from pneumonia in a week or two, but for some people pneumonia can be fatal. There are treatments available for pneumonia, but the best treatment is to prevent getting sick in the first place. People who are at risk should make sure they get a flu shot every year. There is also a vaccine available for the type of bacteria that causes pneumonia.

Lung cancer occurs when abnormal cells inside the lung grow into a tumor, destroying healthy tissue. Because it is so difficult to detect lung cancer in early stages when it has few symptoms, it is the deadliest form of cancer, responsible for the most cancer deaths both in the U.S. and worldwide. Most lung cancer is caused by exposure to tobacco smoke, but between 10-15% of cases are not linked to smoking.

Some problems with the lungs are minor and are not cause for concern. However if symptoms have lasted for a month or more, even if they are minor, it is worth checking with a healthcare professional. A cough, shortness of breath, or excess mucus production that lingers for weeks are all worth getting looked at.

Contrary to popular belief, lung transplant is rarely used to treat lung cancer. It is a more common treatment for patients with other advanced lung diseases, such as cystic fibrosis, sarcoidosis, pulmonary fibrosis, and chronic obstructive pulmonary disease (COPD). Lung transplant is a serious operation and is generally used as a last resort for patients who have only a short time to live without surgery.

During a transplant, an incision is made on the side of the chest (for a single lung) or in the middle (for both lungs). Patients may be hooked up to a heart-lung bypass machine, which will do the work of moving blood and oxygen through the body during the procedure. After the diseased lung is cut away from the main airway and blood vessels, the donor lung is stitched into place. Surgery may take as long as twelve hours, and a hospital stay of two to three weeks after surgery is not uncommon. For the first hours or day after surgery, patients use a ventilator, or a machine to help them breathe. Tubes will be inserted into the chest to help drain excess air and fluid. During recovery, physical therapy and breathing exercises are used to help the new lung work as well as possible.

Lung capacity is carefully monitored for several months after surgery. Patients who have had a transplant will also have to take anti-rejection drugs for the rest of their lives. These drugs stop the body's immune system from attacking the new lung. The main risks after a transplant are infection and rejection (when the immune system attacks the 'foreign' lung). A healthy lifestyle, including maintaining a diet high in vegetables and lean protein, not smoking, and getting enough exercise, is important to keeping the lungs functioning as well as possible. With proper care, many patients can live ten or even twenty years after a lung transplant.