Respiratory – Brisbane Respiratory & Sleep

Respiratory Conditions

We specialise in diagnosing and treating a wide range of respiratory-related issues to help you achieve breathe easier From common disorders like insomnia and sleep apnea to more complex conditions affecting respiratory function during sleep, our team is here to provide personalised care and support. Explore the list below to learn more about each condition, its symptoms, and available treatment options, and discover how we can assist you in achieving better sleep and overall well-being.

Lung Cancer

Unfortunately, lung cancer remains the leading cause of cancer death in Australia with around 15,000 new cases per year and about 9,000 deaths per year. Despite significant advancements in lung cancer treatment over the past decade leading to improved outcomes, the 5-year survival rate is low at 27.3% (2017–2021), with approximately 1 in 30 people expected to be diagnosed by age 85.

The major risk factor is smoking. However, many cases also occur in never smokers. Other risk factors include having emphysema, occupation exposure to carcinogens (arsenic, cadmium, chromium, nickel, silica, and diesel exhaust), asbestos exposure, environmental pollution, previous radiation therapy to the chest, and family history of lung cancer.

Symptoms can include persistent cough, coughing up blood (haemoptysis), chest pain, and weight loss. However, lung cancers often grow silently, causing symptoms only when quite advanced.

Diagnosis typically requires a biopsy using techniques such as bronchoscopy, EBUS (endobronchial ultrasound), CT-guided needle biopsy, or robotic bronchoscopy. Staging investigations consist of a PET/CT scan and may include convex EBUS to sample the chest lymph nodes.

Following diagnosis and staging, a management plan is formulated through a multidisciplinary team of specialists to ensure the best possible treatment and outcomes.

Lung Nodules

Lung nodules are a common finding, and most are benign. These may be picked up as incidental findings on CT scans or during lung cancer screening. Management of lung nodules depends on an assessment of the risk of it being cancer. Important factors include the size and shape of the nodule, location of the nodule in the lung, history of smoking, presence of emphysema, and family history of lung cancer.

Some very small very low-risk nodules do not require any follow-up. Other low-risk nodules are often managed by active surveillance with CT scans. More suspicious nodules typically need to be biopsied. Depending on the size and location of the nodule, biopsy options include radial probe EBUS (a bronchoscopy procedure), CT-guided needle biopsy, and robotic bronchoscopy.

The national lung cancer screening programme (NLCSP) went live in July 2025 is a programme designed to detect early-stage lung cancers in at risk individuals using low-dose CT chest scans. The programme is open to patients aged 50-70 years who have at least a 30 pack-year history of smoking and are current smokers or have quit within the previous 10 years and have no signs or symptoms to suggest lung cancer. If you qualify, your GP can enrol you in the programme.

Please visit the following link for more information: How the National Lung Cancer Screening Program works | Australian Government Department of Health, Disability and Ageing

Asthma

Asthma is a disease affecting the bronchial tubes with the main features being bronchospasm and inflammation. Bronchospasm is due to the abnormal contraction of airways smooth muscle causing the bronchi to become narrow which causes episodes of wheeze, breathlessness, and chest tightness. Inflammation causes cough and increased mucus production, and in certain individuals, if left untreated, it can lead to irreversible narrowing of the bronchial tubes through a process of airway remodelling.

In recent years, the management of asthma has changed significantly. Even mild asthma should now be treated with a combined beta-agonist (reliever) and inhaled steroid (preventer) for both maintenance therapy (if required) and reliever therapy as needed. Guidelines advise against relying solely on short acting beta-agonists like salbutamol (Ventolin). With this approach, asthma can be controlled in most patients. Adherence to treatment is of utmost importance.

However, there is a subgroup of patients whose asthma is not acceptably controlled with this approach. These patients have severe asthma. Thankfully, newer biologic therapies are now available that can dramatically improve asthma control, and more are expected to become available soon. Choosing the correct biologic therapy depends on defining the type of asthma a patient has. The main phenotypes are allergic and eosinophilic asthma.

Chronic Obstructive Pulmonary Disease (COPD)

COPD stands for Chronic Obstructive Pulmonary Disease. There are two main types of COPD – emphysema and chronic bronchitis, although many patients will have a combination of both. Emphysema is irreversible destruction of the air sacs (alveoli). Chronic bronchitis is chronic inflammation of the bronchial tubes with excess mucus production causing bronchial narrowing and blockage by mucus. Both conditions lead to obstruction of airflow causing breathlessness on activity.

The main cause of COPD is smoking. Long-term occupation dust exposure can be a contributing factor. It can sometimes occur as an end-result of other respiratory diseases such as chronic asthma and bronchiectasis. Unfortunately, smoking can cause serious damage to the lung tissue and bronchial tubes before the patient develops any symptoms. Patients with COPD are prone to infective exacerbations that are typically treated with antibiotics, often in combination with courses of prednisolone.

Like asthma, we try to phenotype COPD to choose the most appropriate treatment. Bronchodilator therapy is indicated for any breathless COPD patient while inhaled corticosteroid therapy which has anti-inflammatory properties, is typically reserved for patients who suffer from frequent exacerbations. Non-drug therapies are an important part of management, including smoking cessation, exercise, and preventative measures such as vaccinations to reduce the risk of infective exacerbations. Pulmonary rehabilitation is available.

Asbestos-Related Conditions

Asbestos exposure can lead to a range or respiratory conditions ranging from benign asbestos-related pleural plaques, rounded atelectasis, benign asbestos pleural effusions, diffuse pleural thickening, asbestosis, and cancers including lung cancer and mesothelioma.

Pleural plaques are areas of focal thickening of the lining of the lungs (pleura). These plaques are composed of bland collagen and often become calcified. Pleural plaques are a sign of asbestos exposure, although the level of exposure leading to these can be relatively low. Pleural plaques are benign. They rarely cause symptoms and do not impact on lung function. They do not turn into cancer.

The term asbestosis is confined to the condition of fibrosis (scarring) of the lungs due to asbestos. This disease mostly occurs in patient who have had quite high long-tern occupational asbestos dust exposure. It is often progressive and can be very disabling. There is no treatment that can halt or reverse the disease but antifibrotic therapy can slow down the rate of progression.

Pleural mesothelioma is a cancer of the lining of the lung. There is no known safe threshold or dose of asbestos exposure for developing mesothelioma. The risk increases with cumulative exposure, but even brief, low-level, or indirect exposures can lead to the disease, often with a latency period of 25 to 70 years after the initial exposure. While there is no cure, treatment is available to improve symptoms and prolong life.

Bronchiectasis

Bronchiectasis is the abnormal enlargement of the bronchial tubes, typically leading to excess mucus production causing a chronic cough productive of sputum and recurrent chest infections. There are many potential causes of bronchiectasis including inherited conditions (e.g. cystic fibrosis, alpha-1 antitrypsin deficiency), immune deficiencies, some childhood infections (e.g. Whooping cough), chronic infections (e.g non-tuberculous mycobacterial disease), and Allergic Bronchopulmonary Aspergillosis (ABPA). It can also occur in association with some autoimmune conditions such as Rheumatoid arthritis and inflammatory bowel disease. It is not an uncommon finding in COPD. However, in up to 40% of cases, no cause can be found, which is coined “idiopathic”.

Severity and symptoms vary widely, but chronic infection of the bronchial tubes is common, punctuated by infective exacerbations when the airways infection worsens. The cornerstone of management is airway clearance exercises, which help the patient cough up as much of the mucus as possible. A respiratory physiotherapist can teach the patient how to do airway clearance exercises properly. Oscillating positive expiratory (O-PEP) devices can be a useful adjunct, as can nebulised hypertonic saline, which is a concentrated sterile saltwater solution that is inhaled. For some, long-term antibiotic therapy can help. Good nutrition and regular physical exercise are also beneficial.

Interstitial Lung Disease (ILD)

Interstitial Lung Disease (ILD) are a large group of conditions that cause inflammation and scarring in the lungs. The damage mainly affects the lung tissue around the tiny air sacs where oxygen enters the blood. Over time, this scarring can make the lungs stiff, so it becomes harder to breathe and get enough oxygen. Common symptoms include breathlessness, cough and fatigue. There are many different causes of ILD with a wide range of treatment options.

Silicosis

Silicosis is a potentially severe type of lung disease due to inhalation of crystalline silica dust. This most commonly occurs as an occupational exposure. It can affect workers of any occupation that involves cutting, grinding, drilling, excavating stone or products containing stone or occupations using silica sand such as foundry workers. The use of materials containing more than 1% crystalline silica for abrasive blasting has been prohibited for years. Engineered stone benchtops contained very high levels of respirable silica (>90%) resulting in an epidemic of occupational silicosis. The rapid rise in cases of silicosis due to this industry led prompted a world-first ban on engineered stone, effective July 2024, targeting artificial stone with 1% or more crystalline silica.

There are 3 types of silicosis. Acute silicosis develops within weeks or months of exposure to very high levels of silica dust. Accelerated silicosis is due to exposure to large amounts of silica dust for less than 10 years. Chronic silicosis is due to exposure to low levels of silica dust for more than 10 years. Silica exposure can cause enlarged lymph glands in the chest (lymphadenopathy) even before the development of lung disease.

Symptoms can include breathlessness, cough, fatigue, chest pain/tightness and sometimes weight loss. There is no cure. Management may include antifibrotic drug therapy, oxygen therapy, whole lung lavage, and lung transplantation for severe cases. Avoidance of further silica exposure is important, as are lifestyle measures such as exercise and not smoking.

W e s p e c i a l i s e i n d i a g n o s i n g a n d t r e a t i n g a w i d e r a n g e o f r e s p i r a t o r y a n d s l e e p - r e l a t e d i s s u e s t o h e l p y o u b r e a t h e e a s i e r .

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Respiratory Conditions

W e s p e c i a l i s e i n d i a g n o s i n g a n d t r e a t i n g a w i d e r a n g e o f r e s p i r a t o r y a n d s l e e p - r e l a t e d i s s u e s t o h e l p y o u b r e a t h e e a s i e r .

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