Lung cancer ????

[mbrian]

hello doctor,

About 10 years ago I was treated completely for tuberculosis and the duration of treatment was 9 months.

Around 2 years ago, I had some shortness of breath for 2 weeks that went away on its own.
After that whenever I get some cold, I used to feel the shortness of breath and that will go away on its own without treatment. I never took any medication for the last 10 years.

Now the real problem is, for the last 1 week I am again having shortness of breath. It gets worse specially at night. I went to the doctor and he took x-ray, EKG and spirometry and told me that x-ray report and other reports are normal except it has scars which were from my old tb treatment. He denied that it is asthma.
For the last 2 days, I am having this problem almost all the time. I have to yawn to take a breath every now and then.

I have noticed one thing, whenever I get stressed or get cold, I get these problems. There will be no cough, no fever, no wheezing at all just shortness of breath.

For the last two months I have been under lot of stress and anxiety because of work and other emotional issues.

One other important thing is, I was diagnosed with HSV-1, 6 months ago by a routine STD test. But I have never had any symptoms in my entire life. I don't even know if it is oral or genital. Can HSV-1 affect lungs considering the history of TB? Is it lung cancer? I am getting scared when I read about the link between TB and lung cancer and to make that worse I have HSV-1 on top of that.

I read somewhere that HSV-1 affects lungs for immunocompromised people like who have HIV. Do the people who were treated for TB come under immunocompromised categoty? If my immune system is so weak then why didn't HSV-1 show any symptoms to me? I was under the impression that my immune system is strong because I never had any HSV-1 symptoms.

Could you please help me understand what could be the possible reason of my problems?

Thanks for reading,

Regards,
Brian

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

Hi,
Certainly.
Incompletely understood psycho-somatic (mind-body) processes determine the way our body responds to stress. High levels of stress may trigger many physical symptoms including indigestion and breathlessness.
Please try to relax (I know it is easier said than done) and sort out the emotional issues troubling you at present.
Good Luck!

[mbrian]

Hello doctor,

First of all, thanks a lot for your reply, I truly appreciate it.

I will definitely see a pulmonologist as soon as I get an appointment.  You said, it could be a type of ashtma.
I used to run 3 miles daily 1 week ago. Before last week, I used to go gym every day and never had any issues. But for the last 2 weeks I was working 12 hours a day and had been under some really big emotional issues for the last 3 months continuosly so could it be because of stress and mental tension and not by ashtma? Because yesterday I went to my primary doctor and he said that my lungs are clear and there is no sign of ashtma. And 2 years ago also it happened when I was working 12 hours a day in front of computer and rest of the time coping with some other family issues terribly. After that episode, it went away on its own and after that I was again able to run 3 miles a day without any problem and do workout. I used to practice martial arts also.
One another thing, I have noticed is, for the last 3 months, as I have constantly been under lot of stress and noticing poor digestion also so could the poor digestion and emotional stress cause my occasional breathing problems?


Thanks in advance,

Regards,
Brian

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

Hi Brian,

TB is becoming more common in the US and Europe over the past two decades. You took a full course of anti tubercular treatment ten years ago, and have been free of symptoms since then, and recent x-rays too do not show any active TB. This is great.

In my opinion, your symptoms are unlikely to be because of lung cancer. Your x-ray findings and symptoms pattern make this diagnosis very unlikely.

You get episodes of breathlessness triggered by stress, anxiety, cold and other viral respiratory infections. I suspect that this is probably because of hyper-reactive airways. In simpler words, this is a type of asthma. Spirometry and x-rays are often normal in this condition. Please consult a pulmonologist.

HSV in your case may be an incidental finding. It is possible that it may be aggravating your symptoms a bit. But a full-blown viral pneumonitis caused by HSV presents with a completely different picture.

I do not think your immune system is compromised by the TB infection that occured 10 years ago.

Please relax, and see a good pulmonologist and start treatment. You will soon feel much better.

All the best, and God Bless!