Personal Response :
In the earlier days, people used to die of illnesses like tuberculosis and pneumonia. Do you think that
is still the case?
Answers
Answer:
Tuberculosis is caused by infection of lung with small aerobic non-motile bacillus Mycobacterium tuberculosis (MTB). It spreads through the air when people who have an active MTB infection cough, sneeze, or otherwise transmit their saliva through the air. Lung cancer is an etiologically complex disease in which multiple genes are involved in the pathogenesis via different pathways.[5] When these genes interact with the environmental factors, individual may develop lung cancer.
There are some common risk factors like smoking for both pulmonary tuberculosis and lung cancer. Smoking can facilitate the manifestation or detrimental effects of tuberculosis through a variety of mechanisms. First, because smokers tend to have a chronic cough which is also the hallmark symptom of tuberculosis. Diagnosis of tuberculosis may then be delayed leading to a worse prognosis and perhaps higher probability for relapse. Second, smoking is a cause for co-morbidities, such as chronic bronchitis, chronic airway obstruction, pulmonary emphysema as well as coronary heart disease, that may facilitate progression of TB-infection to disease, but also impair lung function in addition to that of tuberculosis alone leading to worse prognosis. Third, iron overload of macrophages in pulmonary tissue is discussed as a direct effect impairing cellular response to micro-organisms. And finally, one could speculate that smokers are less likely to adhere to therapy, at least in certain settings or in certain areas although this may not be a problem in areas that use directly observed therapy for the majority or all of the patients. Cigarette smoking is single most important risk factor for lung cancer. In patients with lung cancer, a history of active tobacco smoking is present in 87% of males and in 85% of females.[6] There is 10-fold increased risk of lung cancer in smokers and 20 times more risk in heavy smokers (< 20 cig/day). The relative risk of developing lung cancer is 2.64 for bidi smokers and 2.23 for cigarette smokers with 2.45 as the overall relative risk.[7]
Other risk factors for pulmonary tuberculosis include:
History of known close contact with someone who has active tuberculosis. Inhalation of airborne nuclei from an infected person is proportional to the amount of time spent in the same air space, the proximity of the person, and the degree of ventilation.
Immunocompromised status (e.g. those with an HIV infection, cancer, transplanted organs, and prolonged high-dose corticosteroid therapy)
Substance abuse (IV or injection drug users and alcoholics).
Any person without an adequate health care (the homeless, particularly children under age 15 years and young adults between ages 15 and 44 yrs)
Pre-existing medical conditions or special treatment (e.g. diabetes mellitus, chronic renal failure, malnourishment, hemodialysis, or transplanted organ)
Institutionalization (e.g. long-term care facilities, psychiatric institutions, prisons)
Living in overcrowded, substandard housing
Being a health care worker performing high-risk activities: Administration of aerosolized pentamidine and other medications, sputum induction procedures, bronchoscopy, suctioning, coughing procedures, caring for the immunosuppressed patient and administering anesthesia and related procedures (e.g. intubation, suctioning)
Other risk factors for lung cancer are
Passive smoking
Exposure to certain metals (chromium, cadmium, arsenic), some organic chemicals, radiation, air pollution.
Atmospheric and occupational agents known as carcinogens like Radon (well-established lung carcinogen), asbestos, arsenic, bischloromethyl ether, chromium, nickel, polycyclic aromatic compounds.
Some viruses like HPV and CMV.
Medical history of tuberculosis
Personal traits (such as having a family history of lung cancer).
Cytogenetic studies have identified many chromosomal changes in lung cancer with numerical abnormalities, and structural aberrations including deletions and translocations. Small cell lung cancer is associated with oncogenes, like c-myc, L-myc, N-myc, c-raf and tumor suppressor genes, like p53 and Rb. Non-small cell lung cancer is associated with K-ras, N-ras, H-ras, c-myc, c-raf and tumor suppressor genes like p16 and Rb genes
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