Dear Ms King,
Thank you for your query at DoctorSpring.com
Lung cancer risk prediction is extremely difficult, and not just dependant on smoking index. Lots of factors like occupation, genetics, radon, asbestos etc play a big role in development of lung cancer.
A pack year of 35 cannot be extrapolated into exact risk of lung cancer. However it is significantly high and can be associated with other diseases such as copd. You already do have early evidence of emphysema.
Taking into consideration of nodules, cyst and air trapping, I do concur with a diagnosis of LCH, and think you might be at a slightly increased risk for pneumo thorax, and effusion.
I will not sit back and relax with just a single diagnosis. Suggest follow up CT thorax after 3 months to assess its progression in size of nodules and cyst.
Feel free to discuss further,
Regards
Dr. Jacob George P
MD IDCCM FCCP
Patient replied :
Dear Dr. George P.
I've read where in some cases LCH can regress if a smoker stops smoking. Can you tell me what I can expect if my LCH progresses? Is there a morbidity rate associated with it? Is it possible for my LCH to be in other systems of my body other than just pulmonary?
Dear friend,
The exact etiology of LCH, is unknown. However , majority (90-95%) are past or current smokers.
Most patients will survive the disease if they quit smoking. It's not easy to predict who will remain symptom free, and who may develop life-long problems.
The survival chance and maintaining good quality of life depend on the individual case.
If LCH progress, expect shortened breath, breathlessness. At times, a nodule can break, causing pneumothorax.
It can affect other systems of body such as bone, skin, pituitary. Etc, although seen alone on majority of patients.
Hope this helped.
Regards
Dr. Jacob George P
MD IDCCM FCCP