Histoplasmosis and lung cancer (tar build-up on calcifications)

[tanacat]

I am 40 years old and was diagnosed with Histoplasmosis about 10 years ago after a lung cancer scare in the ER.  I complained of chest pain/back pain whenever I inhaled (turns out it was a pulled back muscle!), but when they took a chest x-ray they discovered 2 spots they thought were cancer, one about the size of a dime and one the size of a nickle...  They diagnosed as histoplasmosis and explained that the spots are large calcifications. I'm still scared of developing lung cancer, as I smoked cigarettes for about 15 years before diagnosis (I quit smoking after that- 1 pack a day was my average- but I've started smoking occassionally the past few years since having children (helps me relax).   My fear is that the tar from cigarettes have accumulated on the calcifications and never left because the cilia can't 'clean' the tar off them and that I'm adding more when I smoke occassionally.  Am I doomed to lung cancer? (having kids is making me worry about dying)  Are there any new medical ways like laser or surgery to take out these calcifications?  Should I never, EVER smoke again???

[Kamal S Saini, MD, MRCP (UK), DM]

Hi Tana,
You have had histoplasmosis many  years ago. This infection caused inflammation in the lungs which led to scarring. Over a period of time, calcium was deposited over the scars which showed up as patches on your X-ray. There is no robust evidence that removing these scars and calcifications will confer you any clinical benefit.
Carcinogens from tobacco in cigarette smoke can get deposited anywhere in the lungs and not selectively on the calcified patches.  
Resolve to quit smoking as it has many deleterious effects.
Good Luck!

[Kamal S Saini, MD, MRCP (UK), DM]

Hi,
No one is ever "doomed to lung cancer", so please do not worry about this.
However, as a general rule, you should understand that smoking is injurious to health. It can cause several diseases apart from lung cancer.
Although there is no convincing data that occasional smoking (a few cigarettes a week) substantially increases the risk of cancer, there is good data to show that the longer one smokes (you have already done over 15 years), the greater the ill-effects.
Dealing with kids can indeed be stressful, but there are better ways of dealing with it than smoking. Children tend to follow the example set by their parents, and surely you would not like your child to smoke one day.
Please quit smoking. Completely. Today.
All the best, and God Bless!

[TandM700]

A related discussion, scaring of the lungs was started.

[tanacat]

My big question is about the calcifications and if tar accunulates on them?  And if there has been research on removing them?

Thank you,  Tana Allen