When to see a pulmonologist? Find out what chronic cough, shortness of breath, and chest pain could mean

If you think your lungs are doing well and will never cause problems, know that this is the organ most often affected by disease.

If you've often ignored a cough or shortness of breath, or treated yourself without consulting a doctor, you likely don't know you could be at risk for a lung condition. Learn what to look out for and when you should see a pulmonologist. In this article, you'll read about the typical symptoms of lung disease and what you should be alert for.

What does a pulmonologist do?

If you're wondering when to see a pulmonologist, it's important to remember that this specialist diagnoses and treats respiratory diseases. A visit to a pulmonologist is recommended if you experience a persistent cough that doesn't subside after several weeks, or if you have breathing problems such as shortness of breath, especially with exertion. Recurrent respiratory infections, such as bronchitis or pneumonia, are also a significant indication that you should consult a specialist. A pulmonologist can help diagnose and treat asthma and other chronic diseases, such as chronic obstructive pulmonary disease (COPD). It's also important for smokers or those with long-term exposure to lung irritants to have their respiratory health regularly monitored. Additionally, if you have a family history of lung diseases, such as lung cancer, regular visits to a pulmonologist can be crucial for early detection and prevention. A pulmonologist also diagnoses and treats sleep-related breathing disorders, such as sleep apnea. Don't ignore symptoms such as chest pain or increased fatigue, which may be related to lung problems - a pulmonologist will help determine the cause and appropriate treatment.

TUBERCULOSIS – what is this lung disease?

Infection occurs through the respiratory tract, through contact with a sick person who releases tuberculosis bacilli during conversation, laughter, or coughing. Fortunately, not every contact with these microorganisms will result in illness. Various individual factors influence this. It is estimated that approximately 10% of people infected with tuberculosis (5% immediately after infection, and 5% many years later) will develop full-blown disease. In the remaining cases, tuberculosis will be effectively fought by the immune system, resulting in a dormant form. The disease process most often affects the lungs, but tuberculosis bacilli can spread to all organs via the bloodstream.

What are the symptoms of the disease? When should you see a pulmonologist??

Most patients have mild symptoms, which is why the disease is often diagnosed too late. Patients most often experience systemic symptoms:

• recurrent low-grade fever and fever, especially in the evenings,
• night sweats,
• weakness, weight loss,
• chronic cough – first dry, then combined with expectoration of purulent or mucous secretions,
• chest pain,
• dyspnoea
• hemoptysis.

LUNG CANCER – what do you need to know?

Lung cancer is one of the most common malignancies in Poland, with a very poor prognosis. In Poland, 3 to 10% of patients survive five years after diagnosis (depending on the type of cancer and its stage). The most important risk factor for lung cancer is smoking (in 9 out of 10 cases!).

What are the symptoms of the disease?

Unfortunately, most patients develop lung cancer symptoms when the disease is already advanced. The cancer can develop for up to 10 years before symptoms become apparent. Therefore, don't delay seeing a pulmonologist if you experience any of the following symptoms.

The first symptoms most often include:

• chronic cough (especially a change in its character),
• chest pain,
• weakness, progressive weight loss,
• shortness of breath, feeling of shortness of breath, heavy breathing,
• hemoptysis or expectoration of bloody or brownish discharge,
• recurrent pneumonia in the same location.

Lung cancer diagnosis

Early detection of lung cancer can significantly increase the chances of successful treatment and survival. Here are some basic methods used to detect lung cancer:

Imaging test:

• Chest X-ray – This is a basic test that can reveal abnormalities in the lungs, although it cannot always accurately identify lung cancer.
• Computed tomography (CT) – A chest CT scan is more detailed than a traditional X-ray and can detect smaller lesions in the lungs.

Pathological tests:

• Biopsy – This can be performed in various ways, depending on the location of the tumor in the lung. A biopsy allows for microscopic evaluation of lung tissue, which is essential to confirming a cancer diagnosis.
• Bronchoscopy – This is a procedure in which a doctor inserts a thin instrument with a camera through the mouth or nose into the airway to examine the inside of the airway and take tissue samples.
• Thoracoscopy – A minimally invasive surgical procedure used to view the spaces inside the chest and take tissue samples.

Molecular tests:

• Molecular analysis of the tumor – This can provide information about specific genetic mutations in cancer cells, which is crucial for the selection of targeted therapy.

Blood tests:

• Although blood tests are not a direct method of detecting lung cancer, they can help identify biological markers associated with cancer or monitor a patient's overall health.

COPD (Chronic Obstructive Pulmonary Disease) – what do you need to know?

COPD is a chronic, progressive disease, especially with ongoing exposure to lung-damaging agents (harmful dust or gases, primarily tobacco smoke – 80%). It is characterized by persistent airflow limitation due to narrowing of the airways, emphysema, mucus overproduction, and impaired gas exchange. It is the third leading cause of death worldwide.

What are the symptoms of the disease? Symptoms of chronic obstructive pulmonary disease include:

• chronic cough with sputum production, most common in the morning, rarely at night,
• shortness of breath – usually daily, initially on exertion, increasing over time, and finally at rest,
• wheezing.

The development of COPD increasingly impacts the patient's functioning and limits their independence, and exacerbations necessitate numerous hospitalizations. Quitting smoking at any stage of the disease slows the rate of lung function loss and, therefore, further progression.

How to prevent lung diseases?

1. In the case of tuberculosis, the greatest preventative measures are a healthy lifestyle, a proper diet, and maintaining a strong immune system . Vaccinating children during the neonatal period protects them against severe forms of tuberculosis. Early detection and immediate treatment are also crucial to minimize the spread of tuberculosis (after two weeks of treatment, most patients lose their ability to infect).
2. For lung cancer and COPD, the most important step is to stop smoking. It's important to remember that passive smoking is also harmful. This likely applies to e-cigarettes as well.
3. Hygiene is crucial. Remember to frequently ventilate rooms and cover your mouth when coughing or sneezing with a tissue, or if you don't have one, with the crook of your elbow (not your hand, as this can spread bacteria).
4. It's important to maintain good health throughout your entire body, including proper nutrition and good physical fitness. Exercising increases lung performance and capacity and prevents excess weight.

IMPORTANT! For any respiratory infection that is chronic or presents with unusual symptoms, consult your doctor..

Medical consultation with Anna Dudzińska, MD