Prof. Arshad Hussain
At the recently held Conference on Lung Diseases, TB/HIV, Dr. Syed Arshad Husain, Chest Specialist presented an interesting paper on Interventional Bronchoscopy in which he explained about the Crytherapy technique of Freezing Cancer Cells. It causes death of cancer cells. This treatment brings relief to the patients. On this occasion Dr. Arshad Husain was interviewed by our Assistant Editor, Sultan Taher.
Q – Please tell us something about yourself.
Ans – I am currently working at Liaquat National Hospital, Karachi as Assistant Professor in Chest Medicine department and before that I was working as Chest Consultant in UK. In UK, I was running a course for the in Interventional Bronchoscopy – training them to use these latest interventional techniques in Chest Medicine. I was lucky enough myself to be able to get excellent training opportunities in usage of the equipments and techniques in interventional bronchoscopy. I went to Lillee in France and also to Royal Brompton Hospital in London where I took training in this particular specialist field in Pulmonary Medicine interventional Bronchoscopy.
My aim and intentions are to transfer the technology in Pakistan setting and bringing these modalities of Bronchoscopy treatments to help people in Pakistan. As a Consultant, I worked for few years in UK where I had these special services available there mainly freez-ing the lung cancer tumour through application of low temperatures.
Q – Lung diseases are on the increase. What is the prevalence of lung diseases like TB, Asthma, etc.
Ans – As we grow in urbanization, the level of pollution increases, smoking is still on the increase and so the Lung diseases are also on the increase i.e TB, Asthma and Lung Cancer. These are on the increase. So more people have respiratory problems as pollution increases and then there are no remedial measures taken to reduce the pollution levels in our country. The pre-valence is very high in our po-pulation especially Bronchial Asthma.
Q – Your presentation at the Pakistan Chest Society and Lung Diseases/TB and HIV Annual Conference in Karachi recently was on Interventions in PulmonaryMedicine. Please give details.
Ans – Yes, my presentation was on Interventional Bronchoscopy. This is a procedure of multiple modality treatment used for both diagnostic as well as therapeutic reasons. Interventional Bronchoscopy is at the cutting edge for new interventions in Chest Medicine.My main interest is in the technique of freezing the tumour cells in lung cancer called Cryotherapy (i.e. freezing the lung cancer tumour). By Freezing, the tumour cells which are growing rapidly, this freezing effects causes cell death for cancer cells. Most of the symptoms improve with this treatment, like shortness of breath, bleeding disappear and lung cancer tumour disappears for a good amount of time period giving them relief of these symptoms with good quality of life. Another modality is Auto Fluorescence Bronchoscopy. In this modality early detection of lung cancer can be done by use of blue light (autoflorescence light) as opposed to white light the normal bronchoscopy light.
Another useful and important modality is Trans Bronchial Needle Aspiration (TBNA). Through TBNA Biopsy early detection, diagnoses and staging of the lung cancer can be done. Patient could have biopsies of the lymph glands outside the airways.
TBNA combined with Endobronchial Ultrasound (EBUS) is done, then sensi-tivity and specificity increases from 45 percent to around 97 percent.
Q – What about Asthma.
Ans – In Asthma Thermoplasty (applying radiofrequency waves to smooth muscles of the airway tract) treatment can be provided through the bronchoscope with good results and better control of Asthma.
Q – How effective is the TB control program and what is its progress.
Ans – We are trying a lot to control TB spread, but unfortunately the results and the reality, we see are not very good. More should be done by government as well as doctors in our fight against TB in different TB patients where diagnosis is not easy. Bronchoscopy can help, again to confirm diagnosis of TB when the other usual tests fail like help from Broncho alveolar lavage. Through Bronchoscopy the strains and type of TB is confirmed and also indicates if it is sensitive to anti-TB medicines.
Q – Pollution and vehicle emissions are causes of various respiratory diseases. What can be done to reduce vehicle emissions and pollution.
Ans – Through problems of pollution problems and smoking lung diseases like Asthma, COPD and Lung Cancer increase. In Europe where I worked before there is a control over vehicle fuel emissions. It is necessary to work together to cut down vehicle emissions as well as pollution through reducing industrial wastes and pollutions.
Q – It is said that HIV/AID affected persons are at risk to get TB infection, how far it is true.
Ans – It is true. The patients who have compromised immunity, they are more prone to get TB in younger groups of patients. In this area also Bronchoscopy has a significant role in diagnos- ing and correctly treating the Tuberculosis infection.
Q – What are the risk factors that put at risk persons to TB infection.
Ans – Living conditions, poor and overcrowded living conditions lead to increase in spread of pulmonary diseases. Also droplet infection in crowded housing/rooms, lack of awareness about the disease and how it could spread from one person to another especially in cases of open TB(Mycobacterium tuberculosis seen in sputum or phlegm).
Q – How can awareness be created in prevention and treatment of lung diseases.
Ans – The role of Chest Physician and Doctors is quite wide. Our public need to know about the hazards of smoking on lung diseases and also hazards of pollution. Atmospheric pollution is also a cause of higher incidence of prevalence of chest diseases. Medical community can and should spare time in educating their patients thus increasing the awareness in general public especially the poorer section of our community.
Q – When can we expect TB to be completely eliminated from the country. It has already been reduced through efforts of doctors.
Ans – TB is a curable and treatable disease. The treatment available now is much better than ever before. But the main thing is correct diagnosis and prompt treatment. Good preventive measures need to be in place to prevent the spread of the disease and help from public sector and healthcare professional are equally important.
Q – Anything else you would like to add.
Ans – Having worked in UK, I have noticed that in our patients in Pakistan there seems to be a complete lack of understanding about the disease process and how it could be treated. So there is a major role for us as doctors to educate the patients. Certainly a lot more can be done through the print media and television to educate our public.