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Frequently Asked Questions


I am 18 and like to smoke with my friends. My parents freak. What's the big deal?


I was carrying our TV and suddenly felt chest pain and like there was crackles in my neck. In the ER they said there was air around my heart but not to worry. What happened?


What types of lung cancer are there?


I am an ex-smoker and I am concerned about getting lung cancer. Is there a way to screen to catch it early?


I had an X-ray and was told I have a pulmonary nodule. What does this mean?


What is Hyperhidrosis and is there a surgical option for treatment?


My husband's doctor said that his bladder cancer is due in part to smoking. I thought smoking only caused lung cancer. What's the story?


I have been diagnosed with early stage lung cancer and surgery has been the recommended treatment. What are my options?


I keep hearing about cigarettes being bad for you. What about low-tar, cloves, marijuana, pipes, and cigars?


After many years of reflux I have been found by my gastroenterologist to have esophageal cancer. What evaluation and treatments are available?


Is smoking really all that bad for you?


I was just diagnosed with Lung Cancer, what should I do now?


What is mesothelioma?


My family says I sound like I am going to cough up a lung. Is that possible?


I continue to have symptoms of acid reflux despite increasing the dose and frequency of medication. Will I have to take this, or similar medications for the rest of my life?


I'm afraid that if I quit smoking then I will get fat. Will I?


I have tried to quit smoking but it is too hard. Why is that?


If I never smoked, can I still get lung cancer?


My grandmother told me that I shouldn't have surgery for my lung cancer because when the air hits cancer it spreads. Is that true?


My brother was smoking marijuana and dropped a lung. What happened?


I hear there is a medicine that can help me quit smoking. What is it?


I am 18 and like to smoke with my friends. My parents freak. What's the big deal?

Dr. Rose Ganim says:

More than 90% of adults who smoke started before they were 21. Around 30% of 9th graders are already smoking, and they keep on doing it. Few manage to quit. Among adults, almost 25% are smokers. Most kids smoke because they think it's cool and makes them look older. And it works! Smoking breaks down firm parts of your skin, the elastin, and gives you wrinkles making you look older than you are.

 

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I was carrying our TV and suddenly felt chest pain and like there was crackles in my neck. In the ER they said there was air around my heart but not to worry. What happened?

Dr. Rose Ganim says:

Occasionally, if a person strains really hard, like when lifting something heavy, they can burst a little bubble in their lung and it can track to the middle of their chest and show up as air around their heart. It can also track up in the skin of the neck and face and more, and feel like Rice Krispies brand cereal under the skin. Usually, there is chest pain. You should definitely go to the ER if this happens to you, because sometimes it needs urgent treatment.

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What types of lung cancer are there?

Dr. Rose Ganim says:

The first distinction is

  • Primary lung cancer(started in the lung)

 or

  • Cancer metastatic to the lung(started somewhere else, then spread to the lung.

  

There are several types of primary lung cancer, but they are all essentially treated the same way:

  • Surgery if possible
  • Radiation and/or chemotherapy if necessary.

 

Several cancers that spread to the lung also may be treated successfully with surgery.

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I am an ex-smoker and I am concerned about getting lung cancer. Is there a way to screen to catch it early?

Dr. Gary Hochheiser says:

Lung Cancer remains the leading cause of cancer deaths in the US.  Yet, unlike most other cancers, such as Breast cancer and Colon cancer, there are no recommendations at this time for screening.  

 

A number of studies have been performed using Cat Scans, chest X-rays and certain breathing and blood tests, but none have been reliable in detecting cancer and only cancer.  

 

Cat scan has been the most promising, as it can reliably find small cancers, however, it also finds many other things that can mimic cancer.  

 

The answer to this screening question has not been found, but if you are currently, or were a smoker and have a family history of lung cancer and are above the age of 55, it would be reasonable to have a discussion with your doctor about the possibility of a screening test.

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I had an X-ray and was told I have a pulmonary nodule. What does this mean?

Dr. Gary Hochheiser says:

A “nodule” is a lesion in the lung, generally less than 3 centimeters.  Nodules in the lung are not uncommon, and most are not cancer.  However, this is the major question that needs to be answered.   A Cat Scan would be the first step in the evaluation.  The size and shape of the nodule as well as risk factors for cancer, all go into the evaluation.

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What is Hyperhidrosis and is there a surgical option for treatment?

Dr. Gary Hochheiser says:

Simply put, hyperhidrosis is excessive sweating.  It is due to an increased output of the sympathetic nervous system which controls the secretion of sweat.  It usually is very focal occurring in the face, underarms and most commonly the palms of the hands.  Most patients experience sweating that causes water to drip off their hands.  This can be socially and professionally embarrassing.  

There are medical treatments including topical agents, iontophoresis and even Botox injections, however these tend to be temporary.  

There is a surgical procedure with a minimally invasive technique that can control the symptoms permanently.

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My husband's doctor said that his bladder cancer is due in part to smoking. I thought smoking only caused lung cancer. What's the story?

Dr. Rose Ganim says:

The smoke inhaled from cigarettes contains many chemicals that are absorbed into the blood and are toxic to the body.  Several cancers are associated with smoking, and these include:  lung, mouth, laryngeal (voice box), esophagus, stomach, pancreas, kidney, bladder, cervix, and leukemia.  Besides cancer, smoking is associated with heart attacks, strokes, poor circulation leading to amputations, asthma, emphysema, poor healing, wrinkles, yellow teeth, and more!

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I have been diagnosed with early stage lung cancer and surgery has been the recommended treatment. What are my options?

Dr. Gary Hochheiser says:

The standard treatment for early stage lung cancer continues to be surgical removal of the area of the lung that the tumor is in.  There are multiple options for the type of procedure based on the location of the cancer and the fitness of the patient.  

 

New minimally invasive techniques are now available to perform theses lung cancer resections in many instances.  These techniques limit the pain and speed the recovery time as well as decrease the risks of the complications.  The techniques are still relatively new, and you can ask your surgeon about their availability and whether you are a candidate. 

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I keep hearing about cigarettes being bad for you. What about low-tar, cloves, marijuana, pipes, and cigars?

Dr. Rose Ganim says:

They are all bad.  For example, it has long been believed that smoking a joint a day is no big deal because it is only one, and may even prevent cancer.  The opposite is true!  One joint a day seems to carry the same health risks as a whole pack of cigarettes.  Pipes and cigars have risks that are nearly equivalent to cigarettes.

 

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After many years of reflux I have been found by my gastroenterologist to have esophageal cancer. What evaluation and treatments are available?

Dr. Gary Hochheiser says:

Esophageal cancer is the fastest growing type of cancer in the US.  There is a correlation with reflux although most people with reflux will not get cancer.  

 

Once diagnosed, a full evaluation to determine the Stage of the cancer by either a Thoracic surgeon or Medical oncologist should be performed.  This usually includes certain radiologic studies, such as Cat Scan and PET scans to be performed as well as certain endoscopic procedures.  

 

The treatment possibilities include Chemotherapy, Radiation Therapy and Surgery or a combination of these.  The type of treatment depending on the evaluation of the stage and the fitness of the patient.  A multidisciplinary cancer team is usually the best to evaluate what treatment options are best for an individual patient.

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Is smoking really all that bad for you?

Dr. Rose Ganim says:

Yes!  Smoking is our #1 killer and is responsible for 20% of all deaths in the United States each year.  These are deaths due to heart attacks, strokes, emphysema, lung cancer and more.  90% of lung cancers occur in smokers.  Lung cancer kills more men and women each year than colon, breast, and prostate cancers combined.

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I was just diagnosed with Lung Cancer, what should I do now?

Dr. Gary Hochheiser says:

With a new diagnosis of lung cancer, a thorough evaluation must be done to determine how advanced the disease is.  This is called “staging” and usually involves a number of mostly non-invasive tests.  Evaluation by a multiple disciplinary team, with physicians from all areas of lung cancer treatment is ideal to determine the best course of treatment which may involve surgery, chemotherapy or radiation therapy, or combinations of these treatments.

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What is mesothelioma?

Dr. Rose Ganim says:

Mesothelioma is a cancer of the lining of the lung and inner chest wall. Is is almost exclusively associated with exposure to asbestos and is even more likely if a person is also a smoker.

 

There is usually 20 years between the time of asbestos exposure and development of mesothelioma. Many people don’t even know they were exposed. Asbestos is a very good flame retardant, insulator, and filler. Factory, auto, construction, and shipyard workers are most often those affected. It has even been used as gravel in some towns internationally, causing children to be exposed, too.

 

Sometimes it can be treated with surgery, chemotherapy, and/or radiation.

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My family says I sound like I am going to cough up a lung. Is that possible?

Dr. Rose Ganim says:

Not really, but it sure can sound that way, especially if you have a lot of phlegm to bring up.

 

Some people cough so hard that they can:

  • Crack a rib
  • Get a really sore stomach
  • Vomit
  • Even burst little blood vessels in their eyes.

 

If you are coughing that much, you should:

  • See your doctor
  • Get a chest x-ray
  • Quit smoking.

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I continue to have symptoms of acid reflux despite increasing the dose and frequency of medication. Will I have to take this, or similar medications for the rest of my life?

Dr. Gary Hochheiser says:

Not necessarily. Medications will often relieve the symptoms of reflux disease, but actual reflux may still be happening. The only cure for reflux disease is either a laparoscopic surgical procedure or outpatient endoscopic procedure, both of which are available at Baystate.

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I'm afraid that if I quit smoking then I will get fat. Will I?

Dr. Rose Ganim says:

Many people, but not all, who quit smoking gain weight.  This is caused by many things including the need to put something in your mouth (oral fixation) and improved taste buds so food tastes better.  Nicotine from smoking acts as a mild appetite suppressant and increases metabolism slightly.  A healthy diet & exercise can counteract these effects, and can be as easy as a daily 20 minute brisk walk.

 

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I have tried to quit smoking but it is too hard. Why is that?

Dr. Rose Ganim says:

Quitting smoking is the hardest thing that many people ever have to do. It can take four or more tries before you are successful.  Don’t be discouraged, and get help!  Studies have shown that people who get counseling and/ or medications are more likely to succeed.  The effort is worth it!  There are immediate benefits to your blood pressure, heart and lungs.  These translate into long-term improvements too.  Added bonus:  You will also smell better!

 

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If I never smoked, can I still get lung cancer?

Dr. Rose Ganim says:

Yes. Ten percent of people with lung cancer never smoked.

 

A very small number of people have no risk factors, however.  The majority of people in that 10% have been exposed to:

  • Second-hand smoke
  • Radon gas
  • Asbestos
  • Other chemicals or pollution.

 

Lung cancer was VERY rare a hundred years ago before people smoked. Now it is the #1 cancer killer in the USA.

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My grandmother told me that I shouldn't have surgery for my lung cancer because when the air hits cancer it spreads. Is that true?

Dr. Rose Ganim says:

No! The causes of cancer spreading are not very well understood, however, exposure to the air is clearly not the problem.

 

There have been a lot of theories about what makes cancer spread, and why certain cancers tend to spread to specific other parts of the body. You also might think that handling a cancer or bumping into something would make part of it break off and spread, but that is not the case either.

 

If lung cancer can be completely removed by an operation, then that is the best treatment we know of right now.

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My brother was smoking marijuana and dropped a lung. What happened?

Dr. Rose Ganim says:

Dropping a lung is also known as a pneumothorax.

 

In otherwise healthy young people, it is most commonly caused by popping a little bubble on the surface of the lung (called a bleb). Air escapes from the lung into the chest cavity, and the lung deflates like a balloon.

 

It is not clear why it is more likely to happen when smoking marijuana. Sometimes it happens when people cough hard or strain, but often people are sitting still at the time. Usually people feel chest pain and short of breath.

 

A drainage tube is often needed to re-expand the lung, and 1/3 to 1/2 of people end up needing an operation.

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I hear there is a medicine that can help me quit smoking. What is it?

Dr. Rose Ganim says:

Nicotine is a chemical addiction and causes changes in your brain chemistry.  No wonder it is so hard to quit!  Three major types of medications that may help include: 

  1. Nicotine 
  2. Varenicline (Chantix brand) blocks nicotine, reducing both craving and enjoyment of cigarettes 
  3. Bupropion (Zyban, Wellbutrin, brands) reverses some other effects of nicotine withdrawal on brain chemistry. 

Counseling plus medication is probably more effective than medication alone.  Ask your doctor for help!

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