Question

A 55-year-old man with emphysema (a type of chronic lung disease) who has smoked 2 packs of cigarettes per day for 40 years is hospitalized for acute onset of cough productive of bloody sputum (sputum=secretions from deep in the lungs). After a few days of testing and treatment, the patient's nurse reads a physician's note on the chart: "I have told the patient that the etiologies of his hemoptysis are: 1) exacerbation of his chronic emphysema and 2) the new diagnosis of lung cancer. The onsets of both were contributed to by his longstanding smoking."

The patient asks the nurse for more information. Which of the following explanations to the patient best indicates a full understanding of the patient's situation?

a. "You have a disease process that was iatrogenically caused by cigarette smoking."
b. "You have a sudden onset of a chronic lung disease that was brought on by lung cancer."
c. "The coughing up of blood is caused by a worsening of a disease you've had for a long time, plus a new problem-- lung cancer."
d. "These diseases have been creeping up on you for probably 20 years; it just goes to show that you should never have taken up smoking."

Answer 1

The best explanation to the patient is that their condition is caused by a worsening of chronic emphysema and a new diagnosis of lung cancer, both of which are attributed to long-term smoking. Chronic emphysema is not curable, and continued smoking can worsen the condition, while lung cancer treatments depend on the stage and characteristics of the disease.

Step-by-step explanation:

The most accurate explanation for the patient's condition is that the coughing up of blood is caused by a worsening of a disease you've had for a long time, which is your chronic emphysema, and a new problem you are facing, that being lung cancer. Your habit of smoking has been a significant contributing factor to the development and progression of both conditions.

Emphysema, a form of chronic obstructive pulmonary disease (COPD), is characterized by damage to the lung's alveoli. This damage leads to difficulty breathing and is primarily caused by long-term exposure to cigarette smoke. Similarly, smoking is the leading cause of lung cancer, and your years of heavy smoking have significantly increased the likelihood of developing this serious condition. Both diseases reduce lung function and can significantly impact your health.

It is important for you to understand that chronic lung diseases like emphysema are not curable and that continued smoking can exacerbate your condition and accelerate the progression of the disease. Whereas smoking cessation can slow down the worsening of emphysema, effectively mitigating its symptoms. In the case of lung cancer, treatments may vary depending on the stage and specific characteristics of the cancer, but the prognosis is generally more serious.