Breakthroughs & Advancements in Lung Health

Contributed by: Dr Chin Tan Min, Dr Richard Quek

Healthcare experts gathered to discuss the latest advancements and treatment options for lung diseases at the O2 Healthcare Group Annual Lung Seminar.

Asthma, chronic obstructive pulmonary disease (COPD), lung cancer and other lung-related conditions were the focus of the O2 Healthcare Group Annual Lung Seminar. This event offered healthcare professionals an opportunity to deepen their understanding of lung disorders and their treatment options, with eight specialist speakers sharing their expertise during the four-hour session.

Spirometry: Gold Standard for Diagnosing Obstructive Lung Disease

Dr Steve Yang, Senior Consultant in Respiratory and Critical Care Medicine at O2 Healthcare Group, opened the seminar with his presentation on spirometry. This common breathing test plays a crucial role in diagnosing lung diseases, assessing the severity of conditions and monitoring disease progression or response to treatment.

Dr Yang highlighted the importance of this tool, while also noting that some patients might experience dizziness or chest tightness during the test. He explained that spirometry may not be suitable for individuals with conditions such as significant glaucoma, active tuberculosis, viral infections such as COVID-19, or recent sinus or middle ear surgeries. Dr Yang also provided an overview of how to interpret spirometry results, stressing that these results can vary throughout the day due to diurnal variations.

Using GINA to Guide Asthma Treatment in the Community

In his presentation, Dr Tan Aik Hau, Senior Consultant in Respiratory and Critical Care Medicine at O2 Healthcare Group, advocated for the use of strategies and guidelines established by the Global Initiative for Asthma (GINA) to better manage and prevent asthma.

Dr Tan also provided a detailed explanation of the GINA diagnostic flow chart, which guides primary care practitioners in deciding the appropriate course of action based on patient symptoms and treatment history. He advised that patients with persistent or severely uncontrolled asthma, or those at high risk of asthma-related death, should be referred to specialists for more focused care.

Triple Therapy: A New Hope for COPD

Dr Adrian Chan, Senior Consultant in Respiratory and Critical Care Medicine at O2 Healthcare Group, discussed the advancements in COPD treatment during his talk. COPD, which includes emphysema and chronic bronchitis, is a condition characterised by abnormalities in the airways and alveoli. He explained how triple therapy — a treatment combining three medications — has emerged as a promising approach for managing COPD.

Dr Chan also shared evidence showing that single inhaler triple therapy improves treatment adherence in COPD patients, offering new hope for better disease management.

Severe Asthma: When to Use Biologics

Dr Lim Hui Fang, Senior Consultant in Respiratory and Critical Care Medicine at O2 Healthcare Group, spoke on the topic of severe asthma. She clarified the difference between difficult-to-treat asthma — which can be managed in primary care — and severe asthma — which requires specialist intervention. Dr Lim explained that biologics, which target specific antibodies, molecules or cells, are particularly effective for treating severe eosinophilic asthma. She illustrated the benefits of biologics through patient case studies, highlighting the positive outcomes achieved with medications like dupilumab and benralizumab in patients with long-standing asthma and other related conditions.

CT Screening for Early Lung Cancer

Dr Jim Teo, Senior Consultant in Respiratory and Critical Care Medicine at O2 Healthcare Group, addressed the importance of early detection in his presentation. He noted that Asia bears the highest burden of lung cancer globally, and in Singapore, most lung cancer cases are diagnosed at advanced stages.

Dr Teo emphasised the value of low-dose computed tomography (CT) screening for high-risk individuals, particularly long-time heavy smokers, aged 50 to 80. However, he pointed out that a significant proportion of lung cancer patients in Singapore are never-smokers, and that current screening guidelines do not fully account for risk factors such as family history, air pollution and second-hand smoke exposure.

Dr Teo advocated for expanding screening recommendations to include high-risk never-smokers, citing the Lung Cancer Screening in Asia: An Expert Consensus Report. A committee of 18 multidisciplinary lung cancer experts from 11 Asian countries recommended low-dose CT screening be expanded to include high-risk individuals who are defined by age, smoking status and family history of lung cancer. Screening should be undertaken at least every two years and abnormalities followed up every six to 12 months.

Dr Teo concluded by highlighting that early detection through CT screening not only identifies lung cancer but also other chronic lung diseases, offering a better chance of successful treatment.

Lung Cancer in Non-Smokers: How Much We Know

Dr Richard Quek, Senior Consultant in Medical Oncology at Parkway Cancer Centre (PCC), provided insights into the rising incidence of lung cancer among non-smokers. He discussed the complexities of lung cancer in non-smokers, where a single gene mutation can drive the disease. He also highlighted the potential causes, including radon (a naturally occurring radioactive gas) exposure, hereditary genetics and environmental pollution. He stressed the importance of understanding the genetic drivers of lung cancer in non-smokers to tailor treatments that can convert the cancer into a manageable chronic condition.

Dr Quek also noted that scientists have recently discovered that air pollution may trigger lung cancer in never-smokers, when particles linked to climate change promote cancerous changes in airway cells. He raised the suggestion of lung cancer screening in never-smokers and the development of region-specific guidelines based on Asian data, as current guidelines are predominantly Western-centric.

Lung Cancer Case Studies

Dr Chin Tan Min, Senior Consultant in Medical Oncology at PCC, focused on the significant progress made in lung cancer treatment over the past 15 to 20 years. She emphasised the role of precision and individualised medicine in improving patient care and outcomes, underscoring the importance of a multidisciplinary approach.

Dr Chin also highlighted the advancements in targeted treatment, immunotherapy and the introduction of antibody-drug conjugates — the latest innovation in lung cancer therapy, providing oncologists with more treatment options than ever before.

Surgery: Curative Treatment for Early Lung Cancer

Dr Su Jang Wen, Senior Consultant in Cardiothoracic Surgery at O2 Healthcare Group, provided insights into the surgical management of lung cancer. He explained that many lung nodules are underdiagnosed, but the smaller the nodule, the lower the cancer risk.

Dr Su stressed the importance of early surgical intervention, noting that at Stage 0, the five-year survival rate is 99.7% when a small wedge of the lung is removed. Even at Stage 1A1, where a larger wedge is removed, the survival rate remains at around 92%. He advocated for the removal of small nodules detected during CT scans rather than adopting a wait-and-see approach, emphasising that the goal of screening is to catch tumours early for better outcomes.

POSTED IN Cancer Treatments
TAGS cancer survivorship, lung cancer, lung infection
READ MORE ABOUT Lung Cancer
PUBLISHED 01 November 2024