Breathing disorders 101: Bronchitis, COPD, lung cancer & more

highlighted blue healthy lungs on woman body

COPD, lung cancer, bronchitis — everyone’s heard of these disorders.

But unless you or a loved one has experienced them, you may not know how common and impactful they are.

“In Tennessee, the most common lung issues are cancer, asthma and COPD,” says Dr. Ian Bushell, a family medicine physician and medical director for BlueCross BlueShield of Tennessee. “When it comes to lung cancer specifically, Black and Hispanic communities often don’t get treatment due to delayed diagnosis and difficulties accessing care. As a state, we can do better, and that starts with helping everyone understand respiratory disorders so they can seek help when needed.”

What is lung disease?

Dr. Bushell: Lung disease refers to any problem that prevents your lungs from working properly. Breathing disorders are the 3rd leading cause of death in the U.S. and one of the leading causes of death in infants. Tennessee is also one of the top 3 states in the nation for new diagnoses of lung cancer.

6 common lung diseases

1. Asthma 

Asthma is a chronic respiratory condition in which the tubes that carry air overreact, causing:

  • Inflammation
  • Increased mucus production
  • Airflow obstruction

Dr. Bushell: Asthma is a condition that’s typically diagnosed in youth. The tubes in your lungs overreact to stimuli like cold air, smoke, or pollution. These stimuli makes it difficult or impossible to breathe. A person who doesn’t have asthma would have no reaction to these things.

Asthma guide: Causes, triggers & how COVID-19 factors in

2. Cancers

Cancer occurs when abnormal cells divide uncontrollably and destroy the surrounding tissue.

Lung cancer

Lung cancer affects the tissue in and around the lungs, often in the cells that line the airways. It frequently spreads without symptoms and is caused by:

  • Smoking
  • Secondhand smoke
  • Toxin exposure (radon)
  • Family history

Dr. Bushell: In the U.S., lung cancer is the leading cause of cancer death. The most common cause is cigarette smoking, but 15% of people with lung cancer have never smoked.


This cancer develops from the mesothelial cells, which are those that line the membranes of the lungs and other organs in the chest. Mesothelioma is:

  • Often caused by inhaling asbestos
  • May start in the chest and spread to the abdomen or other areas
  • Characterized by shortness of breath and pain in the chest wall

Dr. Bushell: Mesothelioma is a very slow-growing cancer. It often takes 20-40 years for symptoms to become significant enough for someone to seek care. So find out now if your work or hobbies expose you to asbestos.

3. Chronic obstructive pulmonary disease (COPD) 

Dr. Bushell: COPD comes on gradually and worsens over time. It consists of several diseases  — emphysema and chronic bronchitis — that restrict air flow and cause trouble breathing. Doctors may mention any one of these 3 names in discussing your condition. It’s important to know they are all “COPD” and need the same attention and treatment. Tennessee has one of the highest mortality rates of COPD in the U.S., which is why it’s especially important for Tennesseans to know the symptoms.


When you have emphysema, air sacs in the lungs weaken and rupture. That reduces the amount of oxygen supplied to the body.

Chronic bronchitis

This ongoing form of bronchitis occurs when there’s inflammation or irritation in the lining of the airways (bronchial tubes).

Symptoms of COPD

  • Lingering cough
  • Wheezing
  • Chest tightness
  • Shortness of breath
  • Respiratory infections
  • Feeling tired
  • Swelling (edema) in legs, ankles or feet
  • Blue lips or nail beds
  • Unexplained weight loss

4. Cystic fibrosis (CF)

Cystic fibrosis causes thick, sticky mucus to build up in the lungs, pancreas and other body parts. This leads to:

  • Blockages
  • Infections
  • Related damage

Dr. Bushell: Cystic fibrosis is an inherited lung condition that is chronic (ongoing) and progressive (worsens over time). While it is life-threatening, early treatment can improve lung function and quality/length of life.

5. Pulmonary hypertension

This kind of high blood pressure occurs in the arteries that carry blood from the heart to the lungs. Untreated, arteries narrow to the point they can’t carry enough blood, which causes:

  • Shortness of breath
  • Irregular heartbeat (arrhythmia)
  • Right-sided heart failure
  • Death

Dr. Bushell: Pulmonary hypertension happens when arteries tighten and the heart has to pump harder to keep up with normal blood flow. That increases pressure in the arteries and weakens certain parts of the heart. If you experience shortness of breath and fatigue, always discuss that with your doctor. Don’t assume you are “just out of shape.”

6. Tuberculosis (TB)

Tuberculosis is a highly contagious, airborne disease that can affect anyone. Most often it affects people who:

  • Are diabetic
  • Have kidney failure
  • Have HIV
  • Work as health care professionals

Dr. Bushell: Tuberculosis affects 9 million people a year. However, 95% of cases and deaths are in developing countries such as South Africa, India and Vietnam. It’s not typically a big concern in Tennessee unless you have one of the diseases mentioned, or if you’ve traveled to areas where TB is more common or are around someone who has.

4 signs you should talk to a provider

Dr. Bushell: While diagnosing these breathing disorders requires help from a provider, there are signs you can look out for. Contact your provider if you experience:

1. Noise when you breathe 

Breathing should be a silent process. If you clear your throat and still hear a noise when you breathe, that’s a sign of a problem.

2. Persistent or blood-producing cough

A cough that lasts more than a few days or produces blood is worth getting checked out.

3. Shortness of breath

If you have trouble taking a deep breath or catching your breath while doing activities that used to be easy (such as climbing the stairs), there may be a problem.

4. Unintentional weight loss

You might be happy to lose a few pounds, but if you haven’t changed your diet or lifestyle and you’re losing weight, something else is consuming your calories. Get it checked out ASAP.

Dr. Bushell: As I always say, if you don’t have a personal healthcare provider, please get one. If the one you have isn’t right for you, vote with your feet. Choose another! You need the right clinical partner for life.

More from Dr. Bushell on lung health in Tennessee

Ashley Brantley

Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).

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Ashley Brantley has been writing about food, culture and health for more than a decade, and has lived in three of Tennessee’s four major cities (Memphis, Nashville and Knoxville).