Have you ever wondered about how chronic diseases like bronchitis and asthma develop in men?
In this segment, Dr. Matthew Ferrantino will delve into how diseases develop, what treatment options are available, and tips for keeping your lungs healthy.
Selected Podcast
Chronic Lower Respiratory Diseases in Men
Featured Speaker:
Matthew Ferrantino, MD
Matthew Ferrantino, MD is a specialist in pulmonary disease and critical care medicine.He graduated from the University of Rochester School of Medicine and Dentistry in 2004. Transcription:
Chronic Lower Respiratory Diseases in Men
Bill Klaproth (Host): Have you ever wondered about how chronic diseases like bronchitis and asthma develop in men? With us is Dr. Matthew Ferrantino of Rochester Regional Health to help explain chronic lower respiratory disease in men. Dr. Ferrantino, thank you for your time. So, I mentioned bronchitis and asthma. What else would be considered a chronic lower respiratory disease?
Dr. Matthew Ferrantino, MD (Guest): Well, thank you very much for having me. Probably the other main lower respiratory disease that affects men and women would be COPD, which is similar to asthma in some ways, and that stands for Chronic Obstructive Pulmonary Disease, and the obstructive part of that term refers to slowing of airflow as people exhale, which is also an issue with asthma, and by and large, COPD is related to smoking, but also it's related to exposures in a number of different fields where people are exposed to fumes from things like gasoline or chemicals. In Rochester here, a number of people have been in manufacturing, and so it's an issue that we see a lot that incorporates both elements of smoking and other exposures in the context of people’s occupations and hobbies.
Bill: So these exposures to pollutants are the main cause of this?
Dr. Ferrantino: In many people exposures are a main thing that can lead to respiratory diseases. Across the world, being around smoke, particularly from cooking inside people’s homes is a leading cause of COPD, but here in the US, it's mostly related to smoking, but exposures like smoking and allergies and things that are in the environment can definitely affect the health of the airways and the lung tissue both in terms of people with COPD and those folks who have asthma.
Bill: So these types of conditions really aren’t hereditary at all then?
Dr. Ferrantino: There is a hereditary component for a number of them. For COPD there is one gene that we often test for that’s called alpha-1-antitrypsin. That’s a recommendation for folks with COPD to get tested for which is a simple blood test. It's often just a finger stick rather than a blood draw with a needle, and that very rarely can cause damage to the lungs over time because there's a lack of a protein that helps protect the lungs and that particularly affects people who also smoke at the same time, and in terms of asthma, there are definitely family connections between folks who have asthma. So, if your parents have asthma or your siblings have asthma, you're more likely to develop asthma as time passes.
Bill: Ummm hmmm. So these types of diseases then don’t develop in women as much because they're not regularly exposed to these potential toxins?
Dr. Ferrantino: In terms of asthma, that’s relatively evenly distributed between men and women and with regard to COPD because rates of smoking tended to be higher in men than women and because some of the occupations associated with COPD and exposure to some of these chemicals were performed more traditionally by men than women, COPD has generally been thought of as having a male predominance, although with time and as the smoking rates even out a little bit between men and women, there's a sort of a more even distribution, but in general because of the higher smoking rates with men and some of these other occupational exposures, it is more prevalent in male populations.
Bill: And, Dr. Ferrantino, do these diseases take a while to develop then?
Dr. Ferrantino: Definitely. Asthma can show up at any age, from infancy to in people’s 80s, but COPD is a more gradual and sort of an insidious process that occurs over years and years and usually it shows up as the gradual progression of shortness of breath with strenuous activity and then that progresses to shortness of breath with doing more routine things like taking a walk for several minutes, or climbing a flight of stairs and when it's severe, it can progress to being short of breath with just sitting and resting.
Bill: So, when is it time to see the doctor then if someone is experiencing this?
Dr. Ferrantino: In general, if, especially if someone has a history of smoking or history of exposure to chemicals or fumes, and they start to develop shortness of breath, the earlier that it's recognized, the better. There are millions of people with some degree of COPD or chronic lung issues that don’t have a formal diagnosis, and it's often once the symptoms have progressed to the point where they’re really impacting someone’s life, that’s when the diagnosis is made and then there's been a lack of time to start treatment earlier to potentially improve patient’s symptoms over time and their long-term prognosis. So, if someone were to be experiencing shortness of breath that’s starting to limit their activities, or they don’t feel like their breathing and their exercise capacity was quite what it used to be a couple of years ago, particularly if they’ve smoked in the past, that’s a good time to get checked out by their physician.
Bill: So, how do you treat these diseases, then? Is it medicine? Is it lifestyle changes? Potential surgery?
Dr. Ferrantino: For COPD specifically, the main intervention if someone smokes is to have them quit smoking, and there are a number of ways to go about doing that. There’s a resource called the New York State Quit Line, which is available online, and it's also a phone number in addition to medications that are used to help people quit smoking ranging from nicotine patches to other kinds of pills. So, smoking sure cessation is the biggest thing that helps preserve lung over time in someone who has a history of smoking, but if that’s already taken care of, the next steps are just making sure that people stay active as much as they can and then there's a number of combinations of inhaled medicines that are once or twice a day as well as as-needed medication that can help open up the airways and improve airflow and that can help alleviate symptoms and shortness of breath.
Bill: And, in certain patients with COPD, is there a surgery option?
Dr. Ferrantino: Very rarely. If someone has COPD that affects just the upper part of their lung or one particular part of the lung where the lung is damaged. Very rarely that portion of the lung can be removed which is called the lung volume reduction surgery, but nowadays, with some of the other medications that are available and better recognition of the disease, the number of people who that benefits is pretty small. So, generally, there's not a great surgical intervention for people with COPD with the exception of people who have very end-stage lung disease. The ultimate potential treatment for COPD as well as a number of other lung issues would be a transplantation of the lungs which is a very big deal, and it's only done in a number of expert centers across the United States. So, as much as that’s a last option, it is a viable option for folks with very advanced COPD generally under the age of 70 years old.
Bill: Ummm hmmm. And you mentioned lifestyle changes earlier, but what is the general outlook for someone who has a chronic lower respiratory disease?
Dr. Ferrantino: If recognized early and if there's not a significant amount of slowing of airflow or not a significant amount of damage to the lung tissue, the long-term outlook for COPD is excellent. The main things that we focus on are preventing flare-ups of the disease that require antibiotics or treatment with prednisone to reduce inflammation and keeping people out of the hospital. If COPD is advanced or recognized late, often people need supplemental oxygen to wear at home or just with exerting themselves and in that context, the medications we have cannot necessarily reverse the disease, but the goal would be to try to prevent any further progression over time. So, COPD has a very diverse potential prognosis from minimal symptoms for years and years to unfortunately progression or shortness of breath over months to years despite all the things that we have available to treat them.
Bill: And how about bronchitis and asthma?
Dr. Ferrantino: Asthma in general has an excellent long-term prognosis. There are certainly, people with very severe asthma that the treatments that we have available are not as effective as we’d like, but by and large, some of the newer medications that are available over the last five years or so – including inhaled medications, anti-inflammatory medicines like prednisone and other medications which can be given as injections which affect some of the pathways that cause inflammation in the airways have lead to significant improvement in how well we can control asthma and for the majority of patients we can control symptoms very well with the available treatments although certainly people’s symptoms can come and go over time and can get flared up by different triggers like being around allergies or inhalational irritants and such. For bronchitis, that’s most commonly a self-limited issue that either gets better by itself or gets better with the assistance of a short course of an antibiotic or an inhaler to open up the airways or anti-inflammatory therapy.
Bill: So, that’s good news. There is hope and anyone with one of these diseases certainly needs to know that, but I think the key is as you mentioned earlier, it's getting in there quickly and getting a quick diagnosis, not letting it progress. Is that right?
Dr. Ferrantino: Yes, I think a lot of folks attribute slowing down over time to age or lack of activity and so a lot of the issues with gradual progression of shortness of breath can get sort of attributed to other more common things, but if breathing is becoming an issue and people are noticing that they are being limited in their usual activities, it’s a pretty easy way to get checked out would be to do a short breathing test which is called a spirometry, particularly if they do have a history of exposures to some of these irritants or a history of smoking or history of other lung problems in their family and recognizing things early makes it far easier to treat them over time.
Bill: Absolutely and thank you for sharing that great information with us, Dr. Ferrantino. For more information, please visit RochesterRegional.org. That's RochesterRegional.org. You are listening to Rock Your Health Radio with Rochester Regional Health. I'm Bill Klaproth. Thanks for listening.
Chronic Lower Respiratory Diseases in Men
Bill Klaproth (Host): Have you ever wondered about how chronic diseases like bronchitis and asthma develop in men? With us is Dr. Matthew Ferrantino of Rochester Regional Health to help explain chronic lower respiratory disease in men. Dr. Ferrantino, thank you for your time. So, I mentioned bronchitis and asthma. What else would be considered a chronic lower respiratory disease?
Dr. Matthew Ferrantino, MD (Guest): Well, thank you very much for having me. Probably the other main lower respiratory disease that affects men and women would be COPD, which is similar to asthma in some ways, and that stands for Chronic Obstructive Pulmonary Disease, and the obstructive part of that term refers to slowing of airflow as people exhale, which is also an issue with asthma, and by and large, COPD is related to smoking, but also it's related to exposures in a number of different fields where people are exposed to fumes from things like gasoline or chemicals. In Rochester here, a number of people have been in manufacturing, and so it's an issue that we see a lot that incorporates both elements of smoking and other exposures in the context of people’s occupations and hobbies.
Bill: So these exposures to pollutants are the main cause of this?
Dr. Ferrantino: In many people exposures are a main thing that can lead to respiratory diseases. Across the world, being around smoke, particularly from cooking inside people’s homes is a leading cause of COPD, but here in the US, it's mostly related to smoking, but exposures like smoking and allergies and things that are in the environment can definitely affect the health of the airways and the lung tissue both in terms of people with COPD and those folks who have asthma.
Bill: So these types of conditions really aren’t hereditary at all then?
Dr. Ferrantino: There is a hereditary component for a number of them. For COPD there is one gene that we often test for that’s called alpha-1-antitrypsin. That’s a recommendation for folks with COPD to get tested for which is a simple blood test. It's often just a finger stick rather than a blood draw with a needle, and that very rarely can cause damage to the lungs over time because there's a lack of a protein that helps protect the lungs and that particularly affects people who also smoke at the same time, and in terms of asthma, there are definitely family connections between folks who have asthma. So, if your parents have asthma or your siblings have asthma, you're more likely to develop asthma as time passes.
Bill: Ummm hmmm. So these types of diseases then don’t develop in women as much because they're not regularly exposed to these potential toxins?
Dr. Ferrantino: In terms of asthma, that’s relatively evenly distributed between men and women and with regard to COPD because rates of smoking tended to be higher in men than women and because some of the occupations associated with COPD and exposure to some of these chemicals were performed more traditionally by men than women, COPD has generally been thought of as having a male predominance, although with time and as the smoking rates even out a little bit between men and women, there's a sort of a more even distribution, but in general because of the higher smoking rates with men and some of these other occupational exposures, it is more prevalent in male populations.
Bill: And, Dr. Ferrantino, do these diseases take a while to develop then?
Dr. Ferrantino: Definitely. Asthma can show up at any age, from infancy to in people’s 80s, but COPD is a more gradual and sort of an insidious process that occurs over years and years and usually it shows up as the gradual progression of shortness of breath with strenuous activity and then that progresses to shortness of breath with doing more routine things like taking a walk for several minutes, or climbing a flight of stairs and when it's severe, it can progress to being short of breath with just sitting and resting.
Bill: So, when is it time to see the doctor then if someone is experiencing this?
Dr. Ferrantino: In general, if, especially if someone has a history of smoking or history of exposure to chemicals or fumes, and they start to develop shortness of breath, the earlier that it's recognized, the better. There are millions of people with some degree of COPD or chronic lung issues that don’t have a formal diagnosis, and it's often once the symptoms have progressed to the point where they’re really impacting someone’s life, that’s when the diagnosis is made and then there's been a lack of time to start treatment earlier to potentially improve patient’s symptoms over time and their long-term prognosis. So, if someone were to be experiencing shortness of breath that’s starting to limit their activities, or they don’t feel like their breathing and their exercise capacity was quite what it used to be a couple of years ago, particularly if they’ve smoked in the past, that’s a good time to get checked out by their physician.
Bill: So, how do you treat these diseases, then? Is it medicine? Is it lifestyle changes? Potential surgery?
Dr. Ferrantino: For COPD specifically, the main intervention if someone smokes is to have them quit smoking, and there are a number of ways to go about doing that. There’s a resource called the New York State Quit Line, which is available online, and it's also a phone number in addition to medications that are used to help people quit smoking ranging from nicotine patches to other kinds of pills. So, smoking sure cessation is the biggest thing that helps preserve lung over time in someone who has a history of smoking, but if that’s already taken care of, the next steps are just making sure that people stay active as much as they can and then there's a number of combinations of inhaled medicines that are once or twice a day as well as as-needed medication that can help open up the airways and improve airflow and that can help alleviate symptoms and shortness of breath.
Bill: And, in certain patients with COPD, is there a surgery option?
Dr. Ferrantino: Very rarely. If someone has COPD that affects just the upper part of their lung or one particular part of the lung where the lung is damaged. Very rarely that portion of the lung can be removed which is called the lung volume reduction surgery, but nowadays, with some of the other medications that are available and better recognition of the disease, the number of people who that benefits is pretty small. So, generally, there's not a great surgical intervention for people with COPD with the exception of people who have very end-stage lung disease. The ultimate potential treatment for COPD as well as a number of other lung issues would be a transplantation of the lungs which is a very big deal, and it's only done in a number of expert centers across the United States. So, as much as that’s a last option, it is a viable option for folks with very advanced COPD generally under the age of 70 years old.
Bill: Ummm hmmm. And you mentioned lifestyle changes earlier, but what is the general outlook for someone who has a chronic lower respiratory disease?
Dr. Ferrantino: If recognized early and if there's not a significant amount of slowing of airflow or not a significant amount of damage to the lung tissue, the long-term outlook for COPD is excellent. The main things that we focus on are preventing flare-ups of the disease that require antibiotics or treatment with prednisone to reduce inflammation and keeping people out of the hospital. If COPD is advanced or recognized late, often people need supplemental oxygen to wear at home or just with exerting themselves and in that context, the medications we have cannot necessarily reverse the disease, but the goal would be to try to prevent any further progression over time. So, COPD has a very diverse potential prognosis from minimal symptoms for years and years to unfortunately progression or shortness of breath over months to years despite all the things that we have available to treat them.
Bill: And how about bronchitis and asthma?
Dr. Ferrantino: Asthma in general has an excellent long-term prognosis. There are certainly, people with very severe asthma that the treatments that we have available are not as effective as we’d like, but by and large, some of the newer medications that are available over the last five years or so – including inhaled medications, anti-inflammatory medicines like prednisone and other medications which can be given as injections which affect some of the pathways that cause inflammation in the airways have lead to significant improvement in how well we can control asthma and for the majority of patients we can control symptoms very well with the available treatments although certainly people’s symptoms can come and go over time and can get flared up by different triggers like being around allergies or inhalational irritants and such. For bronchitis, that’s most commonly a self-limited issue that either gets better by itself or gets better with the assistance of a short course of an antibiotic or an inhaler to open up the airways or anti-inflammatory therapy.
Bill: So, that’s good news. There is hope and anyone with one of these diseases certainly needs to know that, but I think the key is as you mentioned earlier, it's getting in there quickly and getting a quick diagnosis, not letting it progress. Is that right?
Dr. Ferrantino: Yes, I think a lot of folks attribute slowing down over time to age or lack of activity and so a lot of the issues with gradual progression of shortness of breath can get sort of attributed to other more common things, but if breathing is becoming an issue and people are noticing that they are being limited in their usual activities, it’s a pretty easy way to get checked out would be to do a short breathing test which is called a spirometry, particularly if they do have a history of exposures to some of these irritants or a history of smoking or history of other lung problems in their family and recognizing things early makes it far easier to treat them over time.
Bill: Absolutely and thank you for sharing that great information with us, Dr. Ferrantino. For more information, please visit RochesterRegional.org. That's RochesterRegional.org. You are listening to Rock Your Health Radio with Rochester Regional Health. I'm Bill Klaproth. Thanks for listening.