Lung Health

A Mediaplanet Guide to Innovation in Respiratory Health

Lung Health

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Discover the personal reason behind her COPD activism

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Loni Anderson

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Read how tailor-made lung cancer treatments are changing lives Learn how three healthcare CEOs are responding to COVID-19

JUNE 2020 | FUTUREOFPERSONALHEALTH.COM

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A Certification Course for Pediatric Asthma Management Goes Online Asthma can have serious negative consequences on a child’s life, which is why continuing education for healthcare providers in managing the condition is so important.

The National Environmental Education Foundation (NEEF) recently launched its “Environmental Management of Pediatric Asthma: Guidelines for Healthcare Providers” free online certification course.

Developed in partnership with the Centers for Disease Control and Prevention (CDC), this accredited eLearning program uses case studies, guided exercises, and open dialogue to help pediatric healthcare providers and clinicians manage environmental asthma triggers and intervention strategies.

“Asthma is considered the most common chronic medical condition in pediatrics. It adversely affects the health and the quality of a child’s life, with increased cost, school days missed, and increased severity of symptoms if not well controlled,” said Dr. Lisa de Ybarrondo, medical director at Northwest Assistant Ministries Children’s Clinic Department of Pediatrics in Houston, Texas. “We believe that it is imperative for all pediatric healthcare providers to be knowledgeable and comfortable integrating the environmental management of pediatric asthma into their practice.”

Michael Pope, Content Marketing Manager, The National Environmental Education Foundation (NEEF)

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An Expert’s COVID-19 Advice for People With Chronic Lung Disease Chronic lung disease, including COPD, asthma, lung cancer, cystic fibrosis and pulmonary fibrosis, affects 36.6 million Americans — who worry about their risk of contracting COVID-19.

“The problem is that if they get infected, depending on the status of their immune system, the status of their chronic lung condition, they are compromised and they are more at risk of developing complications of the infection once they get it,” says Albert A. Rizzo, M.D., chief medical officer for the American Lung Association (ALA).

While most people with COVID19 recover within a few weeks, the disease severely impacts lung func-

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tion and can be life-threatening.

Patients may develop bronchitis or a pneumonia-like lung infection and some patients may develop acute respiratory distress syndrome (ARDS) that may require using oxygen and being placed on a ventilator.

Respiratory failure could result in multi-organ failure and death. Even for patients who recover, the longterm damage to the lungs is not yet known.

Monitor your condition Dr. Rizzo advises people with lung disease to use telemedicine to stay connected with their doctors.

Monitor symptoms like shortness of breath, cough, and temperature regularly. Tell your doctor about any changes.

He says many healthcare providers are assuming patients with symptoms have COVID-19 whether or not patients are tested.

There’s no specific treatment for the coronavirus.

“If you have the symptoms of COVID-19, you’re going to get some of these experimental drugs if you need it,” he says. “The test by itself doesn’t change how you’re going to be treated.”

Precautions The doctor also recommends people with lung disease maintain healthy habits, including proper sleep, diet, and exercise, as well as not smoking or vaping. They should continue their regular medicines.

Precautions against COVID-19 are similar to those used during flu season, including handwashing, keeping hands away from the nose, mouth, and face, wearing a mask, social distancing, and staying home when you’re sick.

Patients may choose to self-quarantine and isolate.

“I think we’re going to be more cognizant of how infections spread and how respiratory viruses spread, so we will be washing our hands more frequently and we’ll probably keep some degrees of social distancing,” says Dr. Rizzo. n Kristen Castillo

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Publisher Nellie Dubin Business Developer Gretchen Pancak Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Tiffany Jackson Lead Editor Mina Fanous Copy Editor Kathleen Walsh Director of Sales Stephanie King Director of Product Faye Godfrey Cover Photo Tiffany Pryor All photos are credited to Getty Images unless otherwise specified.

This section was created by Mediaplanet and did not involve USA Today.

Free E-Learning Course Environmental Management of Pediatric Asthma Earn continuing education units (CEUs) with this free course to help you manage environmental asthma triggers and intervention strategies for your patients.

Register today!

NEEFusa.org/asthma-course 2

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Loni Anderson’s COPD Tragedy Inspired a Lifetime of Tireless Advocacy Actress Loni Anderson was caregiver to both of her parents who suffered from COPD, and now she is spreading the word to try and stop this preventable disease.

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hen actress Loni Anderson became a caregiver to both of her parents suffering from chronic obstructive pulmonary disease (COPD), she says she was surprised to learn they didn’t want to quit smoking.

“I would have thought they would have thrown those cigarettes away immediately because you don’t want to have those coughing fits,” she says. “And my mom would say, ‘I can’t breathe, I can’t breathe,’ and my dad said, ‘I feel like I’m drowning.’ And I would think to myself, ‘And yet, you want another cigarette.’

And that was really shocking to me.”

But, as she points out, she has never been a smoker, so it’s a little harder for her to fully relate to how addicting cigarette smoking can be.

She points out that some have suggested quitting smoking can be as difficult as quitting a drug like heroin. “It’s hard for me to relate to,” she says. “I just saw how they were suffering.”

Anderson, best known for her role as Jennifer Marlowe in the CBS comedy WKRP in Cincinnati, which aired from 1978 to 1982, has been an outspoken advocate for COPD awareness since before many people even knew what COPD was, back when it was still just called emphysema.

COPD is caused by long-term exposure to smoke, most often 4

PHOTO: MICHAEL HELMS

through cigarette smoke, and causes obstruction to the lungs making it difficult to breathe. People with COPD are also at greater risk for developing heart disease, lung cancer, and other diseases. Because both of her parents died of the dis-

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ease, Anderson is passionate about spreading awareness of the danger of COPD, and educating others, especially young people, about the risks.

When Anderson and her sister were growing up, her parents, just like everyone, smoked constantly.

“It was a lifestyle,” she says, “They smoked all the time.” In the office, at cocktail parties, first thing in the morning, Anderson says there was never really a time her parents were not smoking. She and her sister called it the “purple haze.”

From first-hand experience she saw what this lifestyle had done to her parents, tragically shortening their lives by decades.

Anderson has traveled all over the country spreading the word about how to stop this illness, going everywhere from care facilities to high schools. “We went to a lot of senior living facilities and visited with people who were completely disabled,” she says. “It takes all your breath to shower.” She says she would think that seeing a grandparent in this condition would make a person want to think twice and quit smoking, but it’s not as simple as that.

Anderson thinks about all the time she might have had with her parents, who died in their early 50s and 60s, if it hadn’t been for smoking and COPD. They would have gotten to be a part of her children’s lives and watch them grow up, perhaps living for another 30 or 40 years. Sadly, it isn’t a possibility for her. But, she says, she can do what she can to make sure other families don’t suffer the same tragedy. n Lynne Daggett

PHOTO: WEITZ FAMILY

The Story of One Doctor’s Miraculous Recovery Dr. Michael Weitz was given three to six months to live when he was diagnosed with lung cancer.

Fourteen years later, he’s sharing his story of recovery.

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r. Michael Weitz, a physician who practices emergency medicine, was diagnosed with lung cancer in 2006. “I was having trouble swallowing, and as a physician I thought in the back of my head, this is how it begins,” he said. “I wasn’t thinking lung cancer, I was thinking lymphoma or some other cancer, but after multiple consultations with my medical specialist and various tests, it finally confirmed a diagnosis that

seemed like it came out of the blue: advanced lung cancer.”

Even as a physician, Dr. Weitz was surprised to learn that he had lung cancer even though he had never smoked.

“I came to learn that 15 percent of patients that develop lung cancer never smoked at all,” he said. “Typically, there’s a genetic predisposition, but the known carcinogens include not only tobacco smoke but pollution.”

Dr. Weitz was told that he would have three to six months

to live. “In 2006, there weren’t a lot of treatment options for lung cancer,” he said.

The cancer then spread to Dr. Weitz’s brain and spine, requiring more surgeries. But when the situation looked most dire, he was given hope. “It was all thanks to my mother,” he said.

“She’d been watching the national news and there was a story about a man with lung cancer who was basically on his death bed undergoing an experimental treatment called targeted therapy for his specific kind of lung cancer. Remarkably, eight weeks later, he returned to normal life and had an 80 percent reduction in his lung cancer. My mom begged me to get my lung cancer tissue tested for the same type of rare lung cancer mutation, and it turned out, miraculously, that I had the same mutation. My mother saved my life.”

Targeted therapy based on biomarkers is less invasive and can be more effective than chemotherapy and radiation.

“Most of them are pretty simple to take, they’re oral medicines,” Dr. Weitz said.

Dr. Weitz now sits on the board of the Lung Cancer Foundation of America (LCFA), where he advocates for more funding for lung cancer research. “For anyone starting their journey, they should visit the LCFA website (lcfamerica.org) because there’s a wealth of information.”

Given his incredible story of recovery, Dr. Weitz speaks to many patients who are suffering from lung cancer and offers them hope. “I tell them to get full biomarker testing on their lung cancer tissue to determine if there’s a mutation that can be targeted by one of the several new targeted therapy drugs that are available today,” he said. n

An Urgent Call to Listen to Your Body McKenzie Swider has idiopathic pulmonary fibrosis (IPF), a debilitating lung disease that causes progressive scarring in the lungs, but she is not giving up.

“I’m only 28 years old and I’m living as if I’m at the end of my life,” said McKenzie Swider, a wife and mother of five from Puyallup, Washington.

“I’m trying to manage the best I can, but this disease has taken everything from me.”

In the fall of 2017, Swider began losing vision, feeling dizzy, and coughing so hard she couldn’t catch her breath. When she described her symptoms to the doctor, she was told that she was probably dehydrated and to drink more water. So she did.

But five months later, Swider woke up in the middle of the night with her heart pounding, struggling to breathe. Her husband drove her to the emergency room at the local hospital where they took scans of her chest and lungs.

There she received the devastating diagnosis of idiopathic pulmonary fibrosis (IPF) and was told that she had already lost fifty percent of her lung function.

IPF is the most common form of pulmonary fibrosis, which affects more than 200,000 Americans annually. There is no known cure.

Swider was an active mom who enjoyed running, playing with her children, volunteering with her church, and working at a nursery. Now, she has a difficult time even making a trip to the grocery store. She uses supplemental oxygen around the clock and is on the waiting list for a lung transplant.

But she is not giving up. She has become a volunteer ambassador for the Pulmonary Fibrosis Foundation (PFF).

“I want to help doctors and people in health care better understand this disease so they can catch it in the beginning,” said Swider. “As an Ambassador for the PFF, I have found new meaning by raising awareness of pulmonary fibrosis and encouraging people to selfadvocate, so they don’t have to go through what I did.”

She added, “If your body is yelling at you, listen.”

Samantha Simmons, Marketing and Communications Manager, Pulmonary Fibrosis Foundation

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Bespoke Lung Cancer Treatments Are Possible With Biomarkers

Advances in scientific research of biomarkers are driving personalized lung cancer treatments based on patients’ individual genomes.

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xciting develo pm en ts in biomarker research are transforming outlooks for lung cancer patients. Science has advanced to where clinicians can prescribe treatments targeting the patient’s specific genomic mutation that is driving their cancer, which often results in improved outcomes and quality of life.

Deeper understanding A deeper understanding 6

of the multitude of biomarkers that drive some lung cancers — such as METex14, RET, ALK, EGFR, ROS-1, and BRAF — has enabled scientists to develop life-changing treatments.

Since 2015, the U.S. Food and Drug Administration has approved more than 15 lung cancer treatments, the majority of which are biomarker-driven.

For those with an actionable biomarker, typically people with adenocarcinoma, a type of non-small

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Patients can continue doing the things they love, like being a parent, working, exercising, and traveling, even while being treated for... stage IV lung cancer.

cell lung cancer (NSCLC), the positive impact can be substantial. Patients can continue doing the things they love, like being a parent, working, exercising, and traveling, even while being treated for stage IV lung cancer.

Get informed Lung cancer is at the forefront of precision medicine, yet far too many patients have not had the benefit of biomarker testing of their tumor tissue. All people

newly diagnosed with NSCLC should ask their doctor to test their tumor tissue for biomarkers, using technologies such as next generation sequencing, an advanced precision diagnostic that offers a comprehensive profile of the tumor, testing for many biomarkers at the same time with limited amounts of tumor required.

This is truly personalized medicine. n Andrea Ferris, President and CEO, LUNGevity Foundation

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Precision Medicine Is Improving Lung Cancer Outcomes Lung cancer is one of the leading causes of cancer death, but targeted therapy is improving survival rates.

“Today the average survival is about 12-14 months,” says Timothy F. Burns, M.D., Ph.D., assistant professor of medicine, division of hematology-oncology at the University of Pittsburgh.

He says the outlook is improving, thanks to enhanced testing and targeted therapies.

Transforming treatment Historically, lung cancer has had limited treatment options. Recently, researchers have identified multiple oncogenes, or changes in

normal genes, that lead to abnormal cell growth associated with cancer. Targeted therapies, which target the specific oncogenic driver of the cancer growth, have changed the face of lung cancer over the last decade.

“Precision medicine is such an elegant and tailored approach, where identifying the cause of the cancer, and targeting that vulnerability in a very specific way, can lead to enhanced patient outcomes,” says Philina Lee, vice president of marketing and U.S. precision medicine at Blueprint Medicines.

Multiple studies show improved outcomes of precision therapy over traditional

chemotherapy. Targeted therapies are increasing the life expectancy trajectory for lung cancer patients.

Targeted therapies The only way to know if a targeted therapy could potentially work is to know what’s driving the cancer. Doctors can order comprehensive biomarker testing like next-generation sequencing (NGS), testing for a number of biomarkers at once.

“When someone walks in my clinic, about 30-35 percent are going to have a targetable biomarker, so I can give them an FDA-approved oral, targeted therapy versus standard chemotherapy,” says Dr. Burns. “And that per-

centage continues to grow over time as new targeted therapies are discovered.”

Results from biomarker testing can take two-or-more weeks, but with several targetable biomarkers with approved treatments, it is worth the wait to confirm treatment.

“You absolutely need to wait for your full complete biomarker testing results before deciding on your treatment,” says Nikki Martin, director of precision medicine initiatives at LUNGevity Foundation, a lung cancer nonprofit.

She says the testing is like a fingerprint of an individual’s cancer and could potentially match them to a personalized therapy.

Lee is optimistic about the next 5-10 years, she says, “The increasing number of new targeted therapies, continual discovery of new biomarkers, and progress towards making comprehensive biomarker testing a standard practice will transform how we can select these purpose-built therapies for patients with lung cancer.” n Kristen Castillo

Blueprint is advancing new precision therapies to improve the lives of patients with genomically defined diseases.

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In a Q&A, Russell Winwood discusses his COPD diagnosis and deciding to defy the odds and become an even more accomplished athlete.

When were you diagnosed with COPD? What was it like learning to live with the diagnosis?

Initially, I felt very depressed as my prognosis wasn’t great and I didn’t know what the future would hold for me. After a few months of feeling sorry for myself I decided I needed to fight my disease and not let it consume me. Over the past 8

nine years I have developed strategies around exercise and nutrition which have allowed me to significantly improve my quality of life. I have competed in Ironman events and marathons all over the world and live a quality of life the experts tell me is not possible with severe COPD. Symptoms of COPD include shortness of breath, wheezing, coughing, and, often, exhaustion. With all of these symptoms, what made you decide that you were going to try a triathlon?

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When I decided to fight my disease, I knew I need a strategy. Coming from a sporting background I knew exercise was good for you and I knew if I was going to improve my quality of life, I had to be able to exercise. This was the start of developing my nutrition and exercise strategy. I started walking slow, short distances.

Each day I would go out and walk. Each day I would try and increase the speed and distance I walked. It took time, but I gradually built my exercise capacity.

In consultation with my doctor, I undertook a training

PHOTO: RUSSELL WINWOOD

Russell Winwood’s COPD Inspired Him to Become an Ironman

program which gave me solid workouts but plenty of recovery between sessions. A year later I completed my first Ironman triathlon. While I have decided to retire from Ironman events, I’m still running a marathon every year and loving it.

What do you hope your COPD Athlete blog will achieve?

My blog was initially just a form of mental therapy for me, I actually never thought anyone would ever read it. When I discovered that it was getting over 4,000 views per month,

I realized I could use it to help others. I now share my story and strategies in the hope it will help others with their COPD. What advice do you have for recently diagnosed patients?

Quit smoking if you’re a smoker! This will always be No. 1. I wrote an article for the European Respiratory Society about the four pillars of living well with COPD. The number one pillar is knowledge. The more a patient can learn about their disease the better they will be able to manage it. n

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Three Healthcare CEOs on How Their Companies Are Responding to COVID-19 Remote monitoring can help people more easily manage some health conditions at home while they remain under the watchful eye of a healthcare professional. The pandemic caused a surge in some hospitals at a time when they didn’t have sufficient PPE to protect themselves. That created the demand to send patients that had COVID-19 or other health problems that required surveillance home with a remote monitor they could trust. People also had an understandable reluctance to visit hospitals unless absolutely necessary, to minimize contact with potentially infected patients and areas. Driven by these pressures, Masimo SafetyNet™ became an ideal solution.

As they become more popular and patients become more comfortable with them, our remote monitoring and telehealth solutions are likely to become increasingly commonplace, long after the pandemic ends.

Joe Kiani, CEO, Masimo

Nonin Medical is here to support our global healthcare partners during the COVID-19 pandemic. With the rise of COVID-19 across the globe, pulse oximetry has never been more important. The National Institutes of Health has highlighted the importance of pulse oximetry, specifying oxygen saturation of below 93 percent as an indicator of moderate to severe COVID-19 illness.

With our global business partners, we are working diligently to ensure product availability across the globe for both medical professionals and for home use. Our global team at Nonin is committed to delivering the innovative, noninvasive monitoring solutions that medical professionals and patients count on now more than ever.

Dave Hemink, CEO, Nonin Medical

As a global leader in digital health and respiratory medicine, ResMed stands strong with healthcare providers in the COVID-19 crisis, helping patients breathe as they fight this virus. Since the outbreak began, ResMed has shifted many resources to triple production of our ventilators to deliver lifesaving therapy to patients in need around the world. At the same time, we worked quickly to offer digital health tools to clinicians, like cloud-connected remote monitoring for ventilator patients, enabling better care in a socially distanced world. I would like to personally thank the frontline clinical heroes — many thousands of respiratory therapists and nurses, pulmonary and critical care medicine physicians, as well as hospital and clinical staff who set up our ventilators for patients in need and deliver the lifesaving gift of breath. You are the superheroes of this COVID-19 crisis, and we salute you!

Mick Farrell, CEO, ResMed

Read more about their response to COVID-19 at FUTUREOFPERSONALHEALTH.COM

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Should People With Asthma Worry About COVID-19?

People with asthma may wonder if they are particularly vulnerable to COVID-19 and what that means. An expert breaks down the facts.

During an asthma flair-up, airways become more swollen and the muscles around them can tighten, triggering wheezing, cough, chest tightness, and shortness of breath. These symptoms are similar to commonly reported symptoms of COVID-19, so it is understandable that people with asthma are wondering if they are at higher risk for the virus, or if they will have serious complications if they do become infected.

The good news is that, though data is still limited, the information scientists have gathered so far looks positive.

“Currently, there is no evidence of increased infection rates in those with asthma,” explained

Mitchell H. Grayson, M.D., FAAAAI, Chief of the Division of Allergy and Immunology at Nationwide Children’s Hospital. And although the Centers for Disease Control and Prevention (CDC) states that patients with moderate to severe asthma could be at greater risk for more severe disease, there are no published data to support this at present.

Though this is encouraging, nothing has been proven definitively yet, and everyone should still exercise caution.

“Of course, we’re dealing with an evolving pandemic and new information could change the situation,” reminded Dr. Grayson.

But this is not the only source of anxiety for people with asthma. There have also been reports that steroids, common for treating asthma, should not be used in cases of COVID-19. So what should

someone do if their controller medication is an inhaled or oral steroid?

“The short answer is continue taking your controller medications to keep your asthma under control,” said Dr. Grayson. Some data suggests that steroids might increase the shedding of SARS-CoV-2, but these findings came from steroids used specifically to treat hospitalized COVID-19 patients. The effect of steroids used to treat other diseases like asthma on COVID-19 was not studied. The CDC recommends not stopping steroids with COVID-19, if the steroids are being taken for another condition such as asthma.

“Stopping a controller medication will put you at risk for an asthma exacerbation, and treating the exacerbation will likely require going to the emergency department, where there is a much higher risk of being exposed to someone with COVID-19,” emphasized Dr. Grayson.

While there are seasonal versions of coronaviruses that have been shown to cause asthma exacerbations, this does not seem to be true with SARS-CoV-2.

The bottom line for anyone with asthma is continue taking your controller medication, inform your healthcare provider of any symptoms you may develop, practice social distancing, and wash your hands. n American Academy of Allergy, Asthma & Immunology

ALL TOGETHER

NOW For nearly 35 years, Nonin Medical has designed and manufactured noninvasive patient monitoring devices for healthcare professionals and individual users. Nonin pulse oximeters, capnographs, sensors, and software deliver dependable performance, even in challenging environments. Visit www.nonin.com.

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