I was at an Advisory Board meeting in Boston last week with 14 other pulmonary specialists from northeastern United States. We were discussing the problems associated with diagnosing and treating patients with interstitial fibrosis of the lung. There have been several articles in the column in the past concerning this disease, which represents a scarring process in the tissue of the lungs. Once the scars are formed we currently have no medications to remove them. However, we recently have been given two new drugs which appear to slow the progression of the disease and improve survival.

One of the participants, a researcher from the Brigham Hospital in Boston, felt that interstitial fibrosis is much more common than we had previously thought, and that we will see more of this disease being found and diagnosed because we are doing more CT scans of the chest as part of our early detection programs for lung cancer. This researcher is working on the genetic aspects of this disease which could provide biomarkers (blood tests) to help diagnose the disease early in its course.

Because interstitial fibrosis cannot be cured, but the course can be modified, it is important to have a diagnosis early. The work up for this problem requires a number of lab tests and a special CT scan called a high resolution study. Even with these sophisticated tests, we will still occasionally need a lung biopsy. Making the correct diagnosis will lead the best therapy currently available.