Vanderbilt | COPD and Other Stuff

Meet Molly, Cancer Survivor.

Molly is my wonderful re-homed girl and my fourth dog to get cancer in ten years. The only difference is she is still alive. Molly recently had a second cancer surgery and is almost healed.
Most of you already know more than you ever wanted to know about cancer, many of you have have lost loved ones to it. The faces of cancer in my family pale compared to most of you, but let me show you a few glimpses and faces of cancer in my family.

You are welcome to share a cancer photo here with us. Send it to me and I’ll add it here with mine.

Fresh From aDip in Smelly Pond — Hold Still, Ashley, We Will Cool You Down-fresh swim from smelly pond.

Annie Cut Her Baby Teeth on that Bench — Annie - A Favorite Bench

All 164 lbs of him — Mr G''s Buddy, my Mom

MomDogsEaster2000 — Mr Green standing, Annie behind, their Mom Sonja and my mom.

A few years later, June 6, 2008 my mom died from Pancreatic cancer… twelve years earlier my dad died of Prostate cancer.

Cancer, cancer, go away. Don't come back any day. — Molly, Moving Easy at Home and Healing

A Good Healing — Cancer Caused Stitches, a second time around.

A new bamboo shoot emerges — What does a bamboo shoot from a seemingly dead bamboo plant and cancer have in common? Survivors and dedicated researchers.

The Queen Surveys Her World — Sonja Waits for Her Ride

Queen Sonja, Mr. Green and Ms. Annie — Chuck returns Queen Sonja, Mr. Green and Annie ashes home to Ivy St.

The following story is verbatim so that nothing is lost in the telling. Vanderbilt takes cancer personally. Yes.

“Vanderbilt takes cancer personally.

That’s what the dominant Page One headline in today’s Tennessean says. It’s a play on words because the story is about Vanderbilt’s newly announced Personalized Cancer Medicine Initiative. (You can read more in the Vanderbilt-Ingram Cancer Center’s News Center).

But it’s also true in its most literal sense. The nurse who takes calls about this new initiative in the morning and then goes to her own chemotherapy appointment in the afternoon takes it personally. The physician-scientist who can share with his lung cancer patients his own experience with lymphoma takes it personally. The breast cancer survivor whose good friend is now in treatment and who read about this initiative on VICC’s Facebook page this morning takes it personally. The 1 in 2 men and 1 in 3 women among us who will face a cancer diagnosis, well, they have or will take it very personally.

As someone who has been an observer of cancer science for more than 15 years, I can tell you that no one takes this disease more personally than the investigators at the Vanderbilt-Ingram Cancer Center.

For months, Dr. William Pao, who directs the initiative, and his colleagues have focused on every detail, making sure the science was exactly right and the process of delivering on the promise of this discovery could go as smoothly as possible. Much time and energy has been spent in getting the announcement just right and making sure folks who might get questions from patients and families know what this means (and importantly what it doesn’t mean).

Whatever you take away from the coverage of this announcement, please know this. It’s a big deal, one in which everyone at Vanderbilt can and should take pride. No, we didn’t cure cancer this week. But we did demonstrate a leadership role in what many predict will be a sea change in how we diagnose and treat our patients, not only with cancer but with myriad other diseases as well.

So feel free to take it personally. I know I do.”

More later… Sharon O’Hara

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Too many of our returning soldiers have it – the Agent Orange of 2010 – lung disease leading to the good, the bad and the ugly.

The only thing “good” about the following is that it is bringing public attention to an invisible disease and the 4th leading cause of death in the nation, killing 120,000 people a year. COPD is expected to be the 3rd leading cause of death by 2020.

The “bad” is our soldiers were hit by the invisible permanent lung damage of constrictive bronchiolitis.

“…In 2008, Miller and pulmonary/critical care fellow, Matthew King, M.D., pulled together the first round of what they believe is solid evidence that soldiers are returning with serious and permanent lung injuries related to their service….”

“…The soldiers also shared similar stories of exposure in Iraq to massive amounts of smoke from sulfur fires in 2003, or breathing air fouled by sand and smoke from burn pits all over the country. Miller made a… “unconventional” move and recommended surgical biopsies.

“So far, all but a few of these soldiers we have biopsied have had constrictive bronchiolitis,” Miller said…”

The ‘ugly’ is that our soldiers and nation are faced with 2010’s version of ‘Agent Orange.

“… typical example of what may be an emerging profile: a soldier who was fit, a lifelong non-smoker, and who returned from deployment in Iraq with permanent lung damage.

Since 2004, physicians serving the Fort Campbell Army base have been referring dozens of soldiers with exercise-induced shortness of breath to Vanderbilt, to see Robert Miller, M.D., associate professor of Allergy, Pulmonary and Critical Care Medicine. “

“The soldiers also shared similar stories of exposure in Iraq to massive amounts of smoke from sulfur fires in 2003, or breathing air fouled by sand and smoke from burn pits all over the country.

Miller began to wonder if conventional testing might not be enough. He made what he calls an “unconventional” move and recommended surgical biopsies.

“So far, all but a few of these soldiers we have biopsied have had constrictive bronchiolitis,” Miller said.

Constrictive bronchiolitis, also called Bronchiolitis Obliterans, is a narrowing of the tiniest and deepest airways of the lungs.

It is rare, and can only be diagnosed through biopsy. Cases that have been documented in the medical literature show striking similarities to what is seen in the soldier’s biopsies.

“These are inhalation injuries, suffered in the line of duty,” said Miller.

In 2008, Miller and pulmonary/critical care fellow, Matthew King, M.D., pulled together the first round of what they believe is solid evidence that soldiers are returning with serious and permanent lung injuries related to their service.

Most of the first patients biopsied were 101st Airborne soldiers who fought the Mishraq Sulfur Mine fires in 2003. Later, many soldiers reported exposure to burn pits, especially a massive, 10-acre burn pit in Balad, Iraq….”

Deployment in Mosul renders a former marathon runner and mom of 7-year-old daughters “unable to pass her military physical fitness testing.”

“The former marathon runner and mother of 7-year-old twin daughters returned from deployment in Mosul in 2007 unable to pass her military physical fitness testing. Even her colleagues at the Army hospital couldn’t help her pinpoint what was wrong.

When Waters heard about Miller’s work she came to Vanderbilt in 2008. Her biopsy confirmed constrictive bronchiolitis.

“As a medical officer, I am considered fit for duty because I can still work in the O.R., even if it is only one day per week,” Waters said. “But my future is uncertain. Once I leave the service it could be very difficult to get medical coverage because of my preexisting medical condition.”

Miller says he is concerned soldiers continue to be tested for shortness of breath across the country using only conventional methods.

He says surgical biopsy and definitive diagnosis are required just to create the possibility of proper compensation, but even then, there is no guarantee.
“Even with positive biopsy, disability ratings have been highly variable,” Miller said.”

http://www.mc.vanderbilt.edu/reporter/index.html?ID=8270

Thanks to the bright, thinking and unconventional medical folks approach at Vanderbilt and elsewhere, Chronic Obstructive Pulmonary Disease (COPD) is beginning to see the light of day.

More later… Sharon O’Hara

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Tag Archives: Vanderbilt

Vanderbilt Takes Cancer Personally? Me too.

Our Returning Soldiers and Constrictive Bronchiolitis.