Tag: pulmonologist

The Role of Palliative Care in Lung Cancer

Lung cancer occurs when cells in the lungs begin to mutate and proliferate rapidly, forming a mass or growth known as a tumour. These tumours can be benign or malignant. A benign tumour of the lung does not spread to the rest of the body and is usually not fatal. Conversely, lung cancer, also referred to as lung carcinoma, is life-threatening with the potential to spread to nearby tissues as well as to more distant areas of the body. It commonly spreads to the brain, liver, bones, or adrenal glands and can have a significant impact on patients’ lives.

The goal of lung cancer treatment is to cure the patient by early surgery. However, most patients present late and the goal of treatment is then to enhance the quality of life while slowing down the progression of the disease and managing the symptoms. But as patients embark on their journey with lung cancer that has spread, they require relief from pain and other symptoms. In such circumstances, they will need support and care as they navigate these tough times. 

Understanding palliative care

Lung Cancer Singapore

With a multidisciplinary caregiving approach, palliative care aims to alleviate the suffering faced by patients with serious illnesses like lung cancer while providing care and support. Although this type of medical care focuses on relieving pain and other symptoms, it should not be confused with hospice care. Unlike hospice care, which is usually provided at the last stage when a cure is no longer possible, palliative care can be offered at any stage of the disease.

Palliative care for lung cancer involves a multidisciplinary team of medical professionals, including pulmonologists and other doctors, nurses, social workers, and other health care providers. This team will work with the patient’s primary care doctor and lung cancer specialist to create a customised care plan that meets all their individual needs and specifications. Not only is palliative care beneficial in managing a person’s symptoms, but it also addresses their emotional, social, mental, and spiritual aspect as well.

Exploring the types of palliative care

Every patient is unique, and so are their needs, which means the type of palliative care needed will vary from person to person. It may also vary as one progresses through each stage of your lung cancer treatment. Let’s walk through some of the most common types of supportive care for lung cancer and the components that can be improved by this approach:

  • Medication to alleviate pain and fatigue
  • Medication to address the side effects of treatments
  • Therapies to help patients eat better
  • Treatments to open airways and improve breathing
  • Emotional support to mitigate feelings of stress and depression
  • Counselling to guide patients through any fear or anxiety
  • Nutritional supplements for weight loss
  • Offers integrative therapies like massages and mindfulness for relaxation

Furthermore, many patients who were smokers feel guilty about this habit and tend to blame themselves for the condition. Palliative care will be instrumental in addressing these emotions, helping them to attain a sense of acceptance and serenity. The palliative care team will also help patients and their families plan for the future, ensuring that all their concerns and needs are addressed and looked after so that they can live their lives to the fullest.

How to get palliative care and how to make the most of this service?

Communicate your thoughts with your primary care doctor, nurse, or lung cancer specialist so that this care can be provided throughout the treatment process. Palliative care is usually provided in an array of different settings, including hospitals, clinics, hospices and other facilities including the home. You should discuss your preferred palliative care options with your team and explore the most suitable and comfortable approach for you.

As lung cancer is a debilitating condition, many may have to give up their job or reduce their daily work to treat their condition. This can affect them financially, adding more emotional pressure. If such concerns are discussed with their palliative care team, they can refer patients to financial counselling so that these issues can be managed appropriately. Other problems, such as legal concerns or insurance, can also be navigated by connecting patients to the relevant channels or resources.

In Singapore, lung cancer is the third most common cancer accounting for over 13% of all cancer cases. Therefore, when it comes to lung cancer, specialists like pulmonologists will play a key role in providing good quality care for patients. So, if you are concerned about receiving quality palliative care or would like more information, do not hesitate to reach out to our team at Philip Eng Respiratory Clinic; we would be more than happy to guide you.

When do I need to see a pulmonologist, and what to expect?

The respiratory system includes the lungs, trachea, bronchi, pharynx and other organs, and they help facilitate breathing. Suppose you have been diagnosed with lung disease or have trouble breathing, like shortness of breath (dyspnoea); your general practitioner may refer you to a pulmonologist. But what is the role of a pulmonologist? A pulmonologist is a specialist who diagnoses and treats respiratory conditions. These specialists are equipped with the experience and expertise required to address any respiratory illness that you may have. If you have not consulted a pulmonologist before, we will walk you through what can be expected at the clinic and how you can prepare for your visit.

What conditions do pulmonologists treat?

Pulmonologists are trained to diagnose and manage various lung diseases. Some conditions treated or managed by pulmonologists include, but aren’t limited to:

  • Aspergillosis: This is a fungal infection caused by common mould (aspergillus) and causes breathing difficulties.
  • Asthma: Bronchial asthma is a long-term condition that causes breathing difficulties due to the narrowing of the airways.
  • Bronchiectasis: This condition occurs when the airways become widened, thickened, and permanently damaged, making the lungs vulnerable to infection.
  • Bronchitis: In bronchitis, the airways (bronchial tubes) leading to the lungs are inflamed and filled with mucus resulting in a nagging cough.
  • Chronic Obstructive Pulmonary Disease (COPD): COPD is a chronic inflammatory lung disease that causes airflow limitation and breathing difficulties.
  • Emphysema: This type of COPD develops over time and damages the lung tissue due to noxious elements like cigarette smoke.
  • Interstitial lung disease: Interstitial lung disease or diffuse parenchymal lung disease (DPLD) comprises a large group of diseases (over 200 conditions) that causes inflammation and scarring in the lungs.
  • Lung cancer: Lung cancer or carcinoma refers to cancer that forms in the tissues of the lungs; this may spread to lymph nodes and other organs and may even lead to severe consequences and death
  • Pneumonia: Pneumonia can be a viral, bacterial, or fungal infection that causes inflammation in one or both lungs. Symptoms include cough with phlegm or pus, fever, and difficulty in breathing.
  • Pulmonary fibrosis: In this condition, the lungs become thickened and scarred, resulting in breathing difficulties.
  • Pulmonary hypertension: This is a severe condition with abnormally high pressure in the blood vessels that supply blood to the lungs resulting in fatigue and shortness of breath.
  • Sarcoidosis: This rare condition is characterised by clusters of inflammatory cells known as ‘granulomas’; the cause is unknown, but most evidence suggests that it occurs due to an aberrant immune response.
  • Sleep apnea: If you snore loudly and still feel exhausted after a good night’s sleep, you may have sleep apnea; this potentially serious sleep disorder is characterised by frequent breathing ‘stops’ and ‘starts’.
  • Tuberculosis (TB): TB is a potentially serious bacterial infection that mainly affects the lungs but can also affect other parts of the body.

What symptoms and signs indicate you need to consult a pulmonologist?

There are a number of symptoms and signs that may suggest a visit to the clinic. Let’s take a look at a few symptoms:

  • Shortness of breath: If you have been experiencing breathing difficulties during physical activity or rest, this could indicate an underlying respiratory condition.
  • Fatigue: Feeling tired after an activity is normal, but if you feel worn out all the time, this could be a sign of a lung condition such as COPD.
  • Chronic cough: A severe cough or a lingering cough that has lasted for more than three weeks needs to be investigated.
  • Wheezing: This is a high-pitched whistling sound that may occur while breathing; this may be a symptom of conditions such as asthma, pneumonia, bronchitis, and more.
  • Recurrent colds or respiratory infections: Frequent infections need to be further investigated by a pulmonologist.
  • Abnormal imaging investigation findings: If you have any abnormalities on your chest X-ray or CT scan, you may need to get it evaluated by a pulmonologist.
What to expect at the clinic and how to be prepared?

At first, the specialist will take a detailed medical and family history, followed by a physical examination. This is performed to determine the diagnosis and to commence the required management. Depending on your symptoms and medical history, they may also require a few investigations, such as a chest X-ray, spirometry, bronchoscopy, or a CT scan, to make the proper diagnosis.

Being prepared before your appointment will help you make the most out of your visit. Make sure that you bring any relevant past medical records and make a note of your past and current medications, including any over-the-counter (OTC) supplements or vitamins.

It is advisable to wear loose-fitting and comfortable clothing, as you may be required to undergo tests that require deep breathing or physical activity. If you have any questions or concerns, don’t forget to write them down so that you can get them clarified at the clinic. Lastly, it is recommended that you bring a family member to accompany you at the appointment. This will help you be at ease and free from anxiety or stress.