“The two major types of lung cancer are small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).
SCLC accounts for about 13 percentTrusted Source of all lung cancers. It’s less common than NSCLC, according to the American Cancer Society (ACS).
However, SCLC is the more aggressive form of lung cancer. With SCLC, the cancer cells tend to grow quickly and travel to other parts of the body, or metastasize, more easily.
Though the majority of lung cancer cases are non-small cell lung cancer (NSCLC). Doctors stage NSCLC according to how far it has progressed. Stages range from occult (or hidden) cancer to stage 4 cancer, in which multiple organs may be affected.
The staging system helps doctors determine the best treatment plan, and helps individuals with cancer and their families understand the severity of the disease and the outlook.
There are several different staging systems used around the world, but the most widely used approach is known as the TNM system.”
Small and non-small cell lung cancers cause similar symptoms. Sometimes, symptoms do not appear until the cancer reaches a later stage. The symptoms of small and non-small cell lung cancers are similar, but small cell lung cancer spreads more rapidly. A person may be more likely to experience symptoms after lung cancer has reached a later stage. Shoulder pain often occurs due to inflammation or muscle injuries. Less frequently, shoulder pain can be a symptom of lung cancer. Although shoulder pain is not a common symptom of lung cancer, any persistent, unexplained pain warrants a visit to a doctor for further investigation. ”
Medical News Today (https://www.medicalnewstoday.com)
“One in five people worldwide develop cancer during their lifetime. Prevention of cancer has become one of the most significant public health challenges of the 21st century. It has a critical role to play in the fight against cancer. Based on current scientific evidence, at least 40% of all cancer cases could be prevented with effective primary prevention measures, and further mortality can be reduced through early detection of tumours.”
International Agency for Research on Cancer (https://www.iarc.who.int/cancer-topics)
“Williams syndrome (WS) is a genetic condition that is present at birth and can affect anyone. It is characterized by medical problems, including cardiovascular disease, developmental delays, and learning challenges. These often occur side by side with striking verbal abilities, highly social personalities, and an affinity for music. WS occurs equally in males and females and in all cultures worldwide. Williams syndrome is caused by the spontaneous deletion of 26-28 genes on chromosome #7 at the time of conception. The deletion can occur in either the egg or the sperm. It is likely that in most families, the child with Williams syndrome is the only one to have the elastin gene condition in his or her entire extended family. There are two DNA tests that can determine if a person has Williams syndrome. The FISH test and the Microarray.”
William Syndrome (https://williams-syndrome.org/what-is-ws)
Williams syndrome (WS) is a genetic condition that is present at birth and can affect anyone. It is characterized by medical problems, including cardiovascular disease, developmental delays, and learning disabilities. The most significant medical problem associated with WS is the cardiovascular disease caused by the narrowed arteries. WS is also associated with elevated blood calcium levels in infancy. A random genetic mutation (deletion of a small piece of chromosome 7), rather than inheritance, most often causes the disorder. Williams syndrome is considered an autosomal dominant condition because one copy of the altered chromosome 7 in each cell is sufficient to cause the disorder. In a small percentage of cases, people with Williams syndrome inherit the chromosomal deletion from a parent with the condition.
Most cases of Williams syndrome are not inherited but occur as random events during the formation of reproductive cells (eggs or sperm) in a parent of an affected individual. These cases occur in people with no history of the disorder in their family.
However, individuals who have WS have a 50 percent chance of passing it on if they decide to have children. These often occur side by side with striking verbal abilities, highly social personalities and an affinity for music.
WS affects 1 in 7,500 – 10,000 people worldwide – an estimated 20,000 to 30,000 people in the United States. It is known to occur equally in both males and females and in every culture.
Unlike disorders that can make connecting with your child difficult, children with Williams syndrome tend to be social, friendly and endearing. Parents often say the joy and perspective a child with WS brings into their lives had been unimaginable.
But there are major struggles as well. Many babies have life-threatening cardiovascular problems. Children with WS need costly and ongoing medical care and early interventions (such as speech or occupational therapy) that may not be covered by insurance or state funding. As they grow, they struggle with things like spatial relations, numbers, and abstract reasoning, which can make daily tasks a challenge. As adults, most people with Williams syndrome will need supportive housing to live to their fullest potential. Many adults with WS contribute to their communities as volunteers or paid employees; often working at assisted living homes for senior citizens, hospitals and libraries, or as store greeters or veterinary aides.
However, individuals who have WS have a 50 percent chance of passing it on if they decide to have children. The characteristic facial features of WS include puffiness around the eyes, a short nose with a broad nasal tip, wide mouth, full cheeks, full lips, and a small chin. People with WS are also likely to have a long neck, sloping shoulders, short stature, limited mobility in their joints, and curvature of the spine. Some individuals with WS have a star-like pattern in the iris of their eyes. Infants with WS are often irritable and colicky, with feeding problems that keep them from gaining weight. Chronic abdominal pain is common in adolescents and adults. By age 30, the majority of individuals with WS have diabetes or pre-diabetes and mild to moderate sensorineural hearing loss (a form of deafness due to disturbed function of the auditory nerve). For some people, hearing loss may begin as early as late childhood. WS also is associated with a characteristic “cognitive profile” of mental strengths and weaknesses composed of strengths in verbal short-term memory and language, combined with severe weakness in visuospatial construction (the skills used to copy patterns, draw, or write). Most older children and adults with WS speak fluently and use good grammar. More than 50% of children with WS have attention deficit disorders (ADD or ADHD), and about 50% have specific phobias, such as a fear of loud noises. The majority of individuals with WS worry excessively.
Unfortunately there is no cure for Williams syndrome, nor is there a standard course of treatment.
The prognosis for individuals with WS varies. Some degree of impaired intellect is found in most people with the disorder. Some adults are able to function independently, complete academic or vocational school, and live in supervised homes or on their own; most live with a caregiver.
Where you can find additional information about Williams syndrome:
You may find the following resources about Williams syndrome helpful. These materials are written for the general public.
“Your kidneys and circulatory system depend on each other for good health. The kidneys help filter wastes and extra fluids from blood, using a lot of blood vessels. When the blood vessels become damaged, the nephrons that filter your blood don’t receive the oxygen and nutrients they need to function well. This is why high blood pressure is the second leading cause of kidney failure.”
Blood pressure is the force of blood pushing against blood vessel walls as your heart pumps out blood. High blood pressure NIH external link, also called hypertension, is an increase in the amount of force that blood places on blood vessels as it moves through the body.
What are the kidneys and what do they do?
Healthy kidneys filter about a half cup of blood every minute, removing wastes and extra water to make urine. The urine flows from each kidney to the bladder through a pair of thin tubes called ureters, one on each side of your bladder. Your bladder stores urine. Your kidneys, ureters, and bladder are part of your urinary tract system.
How does high blood pressure affect the kidneys?
High blood pressure can constrict and narrow the blood vessels, which eventually damages and weakens them throughout the body, including in the kidneys. The narrowing reduces blood flow.
If your kidneys’ blood vessels are damaged, they may no longer work properly. When this happens, the kidneys are not able to remove all wastes and extra fluid from your body. Extra fluid in the blood vessels can raise your blood pressure even more, creating a dangerous cycle, and cause more damage leading to kidney failure.
How common are high blood pressure and kidney disease?
Almost 1 in 2 U.S. adults—or about 108 million people—have high blood pressure.1
More than 1 in 7 U.S. adults—or about 37 million people—may have chronic kidney disease (CKD).
High blood pressure is the second leading cause of kidney failure in the United States after diabetes, as illustrated in Figure 1.
Figure 1. Causes of kidney failure in the United States
Who is more likely to have high blood pressure or kidney disease?
High blood pressure
You are more likely to have high blood pressure if you
are older. Blood pressures tends to increase with age. Our blood vessels naturally thicken and stiffen over time.
have family members with high blood pressure. High blood pressure tends to run in families.
have unhealthy lifestyle habits. Unhealthy habits such as eating too much sodium (salt), drinking too many alcoholic beverages, or not being physically active can increase your risk of high blood pressure.
are African American. High blood pressure is more common in African American adults than in Caucasian, Hispanic, or Asian adults.
are male. Men are more likely to develop high blood pressure before age 55; women are more likely to develop it after age 55.
Kidney disease
In addition to high blood pressure, other factors that increase your risk of kidney disease are
diabetes
a family history of kidney failure
race or ethnicity—African Americans, Hispanics, and American Indians tend to have a greater risk for CKD
High blood pressure can be both a cause and a result of kidney disease.
What are the symptoms of high blood pressure and kidney disease?
Most people with high blood pressure do not have symptoms. In rare cases, high blood pressure can cause headaches.
Early CKD also may not have symptoms. As kidney disease gets worse, some people may have swelling, called edema. Edema happens when the kidneys cannot get rid of extra fluid and salt. Edema can occur in the legs, feet, ankles, or—less often—in the hands or face.
Symptoms of advanced kidney disease can include
loss of appetite, nausea, or vomiting
drowsiness, feeling tired, or sleep problems
headaches or trouble concentrating
increased or decreased urination
generalized itching or numbness, dry skin, or darkened skin
weight loss
muscle cramps
chest pain or shortness of breath
How do health care professionals diagnose high blood pressure and kidney disease?
High blood pressure
Blood pressure test results are written with the two numbers separated by a slash. The top number is called the systolic pressure and represents the pressure as the heart beats and pushes blood through the blood vessels. The bottom number is called the diastolic pressure and represents the pressure as blood vessels relax between heartbeats.
Your health care professional will diagnose you with high blood pressure if your blood pressure readings are consistently higher than 130/80 when tested repeatedly in a health care office.
Health care professionals measure blood pressure NIH external link with a blood pressure cuff. You can also buy a blood pressure cuff to monitor your blood pressure at home.
Health care professionals measure blood pressure with a blood pressure cuff.
Kidney disease
To check for kidney disease, health care professionals use
a blood test that checks how well your kidneys are filtering your blood, called GFR, which stands for glomerular filtration rate.
a urine test to check for albumin. Albumin is a protein that can pass into the urine when the kidneys are damaged.
If you have kidney disease, your health care professional will use the same two tests to monitor your kidney disease.
How can I prevent or slow the progression of kidney disease from high blood pressure?
The best way to slow or prevent kidney disease from high blood pressure is to take steps to lower your blood pressure. These steps include a combination of medicines and lifestyle changes, such as
being physically active
maintaining a healthy weight
quitting smoking
managing stress
following a healthy diet, including less sodium (salt) intake
No matter what the cause of your kidney disease, high blood pressure can make your kidneys worse. If you have kidney disease, you should talk with your health care professional about your individual blood pressure goals and how often you should have your blood pressure checked.
Medicines
Medicines that lower blood pressure can also significantly slow the progression of kidney disease. Two types of blood pressure-lowering medications, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), may be effective in slowing the progression of kidney disease.
Many people require two or more medications to control their blood pressure. In addition to an ACE inhibitor or an ARB, a health care professional may prescribe a diuretic—a medication that helps the kidneys remove fluid from the blood—or other blood pressure medications NIH external link.
Physical activity
Regular physical activity can lower your blood pressure and reduce your chances of other health problems.
Aim for at least 150 minutes per week of moderate-intensity aerobic activity. These activities make your heart beat faster and may cause you to breathe harder. Start by trying to be active for at least 10 minutes at a time without breaks. You can count each 10-minute segment of activity toward your physical activity goal. Aerobic activities include
biking (Don’t forget the helmet.)
swimming
brisk walking
wheeling yourself in a wheelchair or engaging in activities that will support you such as chair aerobics
Biking is one type of moderate-intensity exercise that can help lower your blood pressure and weight.
If you have concerns, a health care professional can provide information about how much and what kinds of activity are safe for you.
Body weight
If you are overweight or have obesity, aim to reduce your weight by 7 to 10 percent during the first year of treatment for high blood pressure. This amount of weight loss can lower your chance of developing health problems related to high blood pressure.
Body Mass Index (BMI) is the tool most commonly used to estimate and screen for overweight and obesity in adults. BMI is a measure based on your weight in relation to your height. Your BMI can tell if you are at a normal or healthy weight, are overweight, or have obesity.
Normal or healthy weight. A person with a BMI of 18.5 to 24.9 is in the normal or healthy range.
Overweight. A person with a BMI of 25 to 29.9 is considered overweight.
Obesity. A person with a BMI of 30 to 39.9 is considered to have obesity.
Extreme obesity. A person with a BMI of 40 or greater is considered to have extreme obesity.
Your goal should be a BMI lower than 25 to help keep your blood pressure under control.3
Smoking
If you smoke, you should quit. Smoking can damage blood vessels, raise the chance of developing high blood pressure, and worsen health problems related to high blood pressure.
If you have high blood pressure, talk with your health care professional about programs and products to help you quit smoking.
Stress
Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health. Some activities that may help you reduce stress include
being physically active
practicing yoga NIH external link or tai chi NIH external link
listening to music
focusing on something calm or peaceful
meditating NIH external link
Physical activity can reduce stress and lower blood pressure.
How does eating, diet, and nutrition affect high blood pressure and kidney disease?
Following a healthy eating plan can help lower your blood pressure. Reducing the amount of sodium in your diet is an important part of any healthy eating plan. Your health care professional may recommend the Dietary Approaches to Stop Hypertension (DASH) eating plan NIH external link. DASH focuses on fruits, vegetables, whole grains, and other foods that are healthy for your heart and lower in sodium, which often comes from salt. The DASH eating plan
is low in fat and cholesterol
features fat-free or low-fat milk and dairy products, fish, poultry, and nuts
suggests less red meat, sweets, added sugars, and sugar-containing beverages
is rich in nutrients, protein, and fiber
A healthy eating plan includes a variety of healthy, nutritious foods.
A registered dietitian can help tailor your diet to your kidney disease. If you have congestive heart failure or edema, a diet low in sodium intake can help reduce edema and lower blood pressure. Reducing saturated fat and cholesterol can help control high levels of lipids, or fats, in the blood.
People with advanced kidney disease should speak with their health care professional about their diet.
What should I avoid eating if I have high blood pressure or kidney disease?
If you have kidney disease, avoid foods and beverages that are high in sodium NIH external link.
Additional steps you can take to meet your blood pressure goals may include eating heart-healthy and low-sodium meals, quitting smoking, being active, getting enough sleep, and taking your medicines as prescribed. You should also limit alcoholic drinks—no more than two per day for men and one per day for women—because consuming too many alcoholic beverages raises blood pressure.
In addition, a health care professional may recommend that you eat moderate or reduced amounts of protein.
Proteins break down into waste products that the kidneys filter from the blood. Eating more protein than your body needs may burden your kidneys and cause kidney function to decline faster. However, eating too little protein may lead to malnutrition, a condition that occurs when the body does not get enough nutrients.
If you have kidney disease and are on a restricted protein diet, a health care professional will use blood tests to monitor your nutrient levels.
“There’s no cure, so the goal of treatment is to ease your symptoms and slow the disease. Your doctor will also want to prevent or treat any complications and improve your overall quality of life.
One of the best things you can do to stop your COPD from getting worse is to stop smoking. Talk to your doctor about different things you can try.”
Smoking often causes COPD, but in some cases, breathing in toxins from the environment is the cause.
There’s currently no cure for COPD, and the damage to the lungs and airways is permanent.
However, several medications can help reduce inflammation and open your airways to help you breathe easier with COPD.
Short Acting Bronchodilators:
Bronchodilators help open your airways to make breathing easier. Your doctor may prescribe short-acting bronchodilators for an emergency situation or for quick relief as needed.
You take them using an inhaler or nebulizer.
Examples of short-acting bronchodilators include:
albuterol (Proair HFA, Ventolin HFA)
levalbuterol (Xopenex)
ipratropium (Atrovent HFA)
albuterol/ipratropium (Combivent Respimat)
Short-acting bronchodilators can cause side effects such as:
dry mouth
headache
cough
These effects should go away over time.
Other side effects include:
tremors (shaking)
nervousness
a fast heartbeat
If you have a heart condition, tell your doctor before taking a short-acting bronchodilator.
Corticosteroids:
With COPD, your airways can be inflamed, causing them to become swollen and irritated. Inflammation makes it harder to breathe.
Corticosteroids are a type of medication that reduces inflammation in the body, making air flow easier in the lungs.
Several types of corticosteroids are available. Some are inhalable and should be used every day as directed. They’re usually prescribed in combination with a long-acting COPD drug.
Other corticosteroids are injected or taken by mouth. These forms are used on a short-term basis when your COPD suddenly gets worse.
The corticosteroids that doctors most often prescribe for COPD are:
Fluticasone (Flovent). This comes as an inhaler you use twice daily. Side effects can include headache, sore throat, voice changes, nausea, cold-like symptoms, and thrush.
Budesonide (Pulmicort). This comes as a handheld inhaler or for use in a nebulizer. Side effects can include colds and thrush.
Prednisolone. This comes as a pill, liquid, or shot. It’s usually given for emergency rescue treatment. Side effects can include headache, muscle weakness, upset stomach, and weight gain.
Methylxanthines:
For some people with severe COPD, the typical first-line treatments, such as fast-acting bronchodilators and corticosteroids, don’t seem to help when used on their own.
When this happens, some doctors prescribe a drug called theophylline along with a bronchodilator.
Theophylline works as an anti-inflammatory drug and relaxes the muscles in the airways. It comes as a pill or liquid you take daily.
Side effects of theophylline can include:
nausea or vomiting
tremors
headache
trouble sleeping
Long Acting Bronchodilators:
Long-acting bronchodilators are medications that are used to treat COPD over a longer period of time. They’re usually taken once or twice daily using inhalers or nebulizers.
Because these drugs work gradually to help ease breathing, they don’t act as quickly as rescue medication. They’re not meant to be used in an emergency situation.
The long-acting bronchodilators currently available are:
Side effects of long-acting bronchodilators can include:
dry mouth
dizziness
tremors
runny nose
irritated or scratchy throat
upset stomach
More serious side effects include:
blurry vision
rapid or irregular heart rate
an allergic reaction with rash or swelling
Combination Drugs:
Several COPD drugs come as combination medications. These are mainly combinations of either two long-acting bronchodilators or an inhaled corticosteroid and a long-acting bronchodilator.
For people with COPD who experience shortness of breath or trouble breathing during exercise, the American Thoracic Society strongly recommends a long-acting beta agonist (LABA) combined with a long- acting muscarinic antagonist (LAMA).
Triple therapy, a combination of an inhaled corticosteroid and two long-acting bronchodilators, is recommended for those who continue to have shortness of breath or trouble breathing and are currently using LABA and LAMA combination therapy.
Combinations of an inhaled corticosteroid and a long-acting bronchodilator include:
budesonide/formoterol (Symbicort)
fluticasone/salmeterol (Advair)
fluticasone/vilanterol (Breo Ellipta)
Combinations of an inhaled corticosteroid and two long-acting bronchodilators, called triple therapy, include fluticasone/vilanterol/umeclidinium (Trelegy Ellipta).
A 2018 research reviewTrusted Source found that triple therapy reduced flare-ups and improved lung function in people with advanced COPD.
According to current guidelines, the inhaled corticosteroid may be withdrawn if you have not had a flare-up in the past year.
However, it also indicated that pneumonia was more likely to develop with triple therapy than with a combination of two medications.
Antibiotics:
Antibiotics
Regular treatment with antibiotics like azithromycin and erythromycin may help manage COPD.
Long term antibiotic therapy needs further research studies.
Cancer Medications for COPD:
Several cancer drugs could possibly help reduce inflammation and limit damage from COPD.
A 2019 study found that the drug tyrphostin AG825 helped lower inflammation levels in zebrafish.
The medication also sped up the rate of death of neutrophils, which are cells that promote inflammation, in mice with inflamed lungs similar to COPD.
Research is still limited on using tyrphostin AG825 and similar drugs for COPD and other inflammatory conditions. Eventually, they may become a treatment option for COPD.
Different types of medications treat different aspects and symptoms of COPD. Your doctor will prescribe medications that will best treat your particular condition.
Types of surgery for COPD:
Some considerations for surgery candidates include:
You must be strong enough to have the surgery.
You must participate in a pulmonary rehabilitation program.
You cannot be a current smoker.
Some lung surgeries require that the lung damage must be in an area that is localized (a specific area) and can be removed. The decision for surgery is based on the results of many tests. Talk to your doctor to find out if lung surgery is right for you.
There are two types of lung surgery performed to address COPD:
Bullectomy is a procedure where doctors remove one or more of the very large bullae or blebs from the lungs. Bullae are large air sacs that form from hundreds of destroyed alveoli. These air spaces can become so large that they crowd out the better functioning lung and interfere with breathing. For those people, removing the destroyed air sacs improves breathing.
Lung Volume Reduction Surgery (LVRS) is a procedure to help people with severe emphysema affecting the upper lung lobes. LVRS is not a cure for COPD but can improve one’s exercise capacity and quality of life. The goal of the surgery is to reduce the size of the lungs by removing about 30 percent of the most diseased lung tissues so that the remaining healthier portion can perform better. LVRS also can allow the diaphragm to return to its normal shape, helping you breathe more efficiently. The surgery has been shown to help improve breathing ability, lung capacity and overall quality of life among those who qualify for it.
Surgery Transplantation for patients who are candidates:
Lung transplantation can prolong and dramatically improve quality of life for patients with advanced lung diseases. The Center for Advanced Lung Disease and Lung Transplantation at NewYork-Presbyterian/Columbia University Irving Medical Center is one of the oldest in the United States, having performed more than 1,300 lung and heart-lung transplants since 1988. Between 2001 and 2019, with the launch of new program leadership, they performed over 1,000 lung transplants.
Their patient survival rates are much higher than the national average — even though they treat sicker patients than most U.S. centers. We’ve also worked to expand the pool of donor lungs through innovative technologies. Over the years, they have earned a reputation for our clinical expertise and rigorous commitment to excellence.
“To diagnose chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, your doctor will evaluate your symptoms, ask for your complete health history, conduct a health exam and examine test results. The pt is tested through spirometry. Spirometry is a simple test of how well your lungs work. For this test, you blow air into a mouthpiece and tubing attached to a small machine. The machine measures the amount of air you blow out and how fast you can blow it. Also a chest X-ray and/or other tests, such as an arterial blood gas test, which measures the oxygen level in your blood. When you are diagnosed with chronic obstructive pulmonary disease (COPD), which includes chronic bronchitis and emphysema, you likely will have many questions and the answers may not always be clear at first. Not all people with COPD have the same symptoms and treatment may differ from person to person. It is important to talk to your doctor about your treatment options and to get answers to all of your questions.”
American Lung Association (https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/treating)
