Center for Advanced Lung Care

The Center for Advanced Lung Care (CALC) offers comprehensive care for patients with advanced lung and heart-lung diseases and unexplained difficulty breathing. Part of Brown University Health, the center is a national leader in treating and researching these diseases and conditions, while providing all patients with specialized, personalized, and compassionate care.

Led by internationally recognized physicians from The Warren Alpert Medical School of Brown University, the Center for Advanced Lung Care follows a multidisciplinary approach to patient care. This includes a team of pulmonologists, intensivists, cardiologists, interventional radiologists, anesthesiologists, and cardiac and thoracic surgeons along with nurses, respiratory therapists, clinical pharmacists, nurse practitioners, and advanced practice providers.

The Center for Advanced Lung Care treats a wide range of conditions: all forms of pulmonary hypertension (high blood pressure in the lungs), including chronic thromboembolic pulmonary hypertencion (CTEPH), acute and chronic pulmonary embolism (blood clots in the lungs), interstitial lung diseases including pulmonary fibrosis (scarring disorders of the lungs), advanced airways disorders like severe asthma and chronic obstructive pulmonary disease, and provides care for pregnant women with lung disease, sleep disorders or respiratory symptoms.

A Patient-Centered Approach to Lung Disease Care

Patients are assigned a patient navigator to help coordinate appointments and understand referrals, assist with admissions and discharge paperwork and transitions of care, plan care goals for patients, and provide support and education about treatment options.

Regardless of the specific condition and degree of breathing impairment that patients experience when they come to the CALC, it is our goal to return patients to the highest quality of life possible. Although the results may be limited in some patients, our approach can be transformative – an individual experiencing severe shortness of breath who is homebound may return to work, travel, and enjoyment of their day-to-day lives.

Additional Services for Treating Lung Disease

The Center for Advanced Lung Care provides patients and families with the following personalized patient-centered services:

• Comprehensive testing is offered at the CALC location including pulmonary function testing, which assesses breathing patterns, echocardiography, which takes detailed ultrasound images of the function of the heart, imaging, including chest x-rays, CT scans and MRI imaging, as well as exercise testing, which mimics day-to-day life to understand why patients experience shortness of breath and fatigue.
• Pharmacists offer counseling and co-management for complex treatment regimens, medication side effect support, medication reconciliation, and support access to treatment through Brown University Health Specialty Pharmacy.
• Psychologists provide individual and group behavioral health treatment, coordination with palliative care, and psychiatric and psychotherapy referrals for patients and family/caregivers.
• Social workers liaise with physicians and psychologists to coordinate and enhance treatment goals, help patients access financial and other health and social assistance (e.g., in-home oxygen access, housing applications, etc.), create and maintain patient and family/caregiver support groups, and help patients with legal documents (e.g., medical power of attorney, living wills or advance directives).
• Asthma education is offered one-on-one or in a group session.
• Pulmonary and cardiopulmonary rehabilitation.
• Condition-specific support groups are in person and virtual.
• Genetic counseling services.

Advanced Treatments for Chronic Thromboembolic Pulmonary Hypertension (CTEPH)

The Center for Advanced Lung Care is one of only a handful of centers in the United States, and the only center in Rhode Island and southeast New England, that offers advanced treatments for thromboembolic pulmonary hypertension (CTEPH). Our expert physicians effectively perform these procedures and work together in a multidisciplinary team to determine the best course of treatment for every patient. These treatments include:

• Pulmonary Endarterectomy (PEA): For eligible patients, PEA surgery is considered the most effective treatment. Chronic thromboembolic material and fibrotic lesions are removed from the pulmonary arteries, restoring pulmonary blood flow and reducing pulmonary artery pressure. This can lead to significant improvements in symptoms and the patient’s quality of life.
• Balloon Pulmonary Angioplasty (BPA): BPA is a minimally invasive procedure that may be appropriate for patients who are not eligible for PEA or have residual thromboembolic lesions or lesions that cannot be surgically removed. BPA is typically performed in multiple sessions over several weeks to months. During BPA, catheters with balloons are inserted into the pulmonary arteries and the balloons are inflated to open blockages improving blood flow and reducing pulmonary artery pressures.

What Types of Lung Diseases Do We Treat?

The Center for Advanced Lung Care’s multidisciplinary team provides expert care for chronic obstructive pulmonary disease (COPD), asthma, pulmonary fibrosis, interstitial lung disease, pulmonary hypertension, and acute or chronic pulmonary embolism. 

Our team collaborates across specialties to ensure that every patient receives a personalized care plan that reflects the latest advancements in pulmonology and evidence-based practice, thus supporting optimal lung health and an improved quality of life.

What Are the Symptoms of Lung Disease?

Lung disease symptoms can vary depending on the condition, but common signs include:

• Shortness of breath, especially during physical activity or when climbing stairs.
• Chronic cough, which may or may not produce phlegm or mucus.
• Wheezing, a high-pitched whistling sound when breathing, which is a sign of the narrowing or inflammation of the airways.
• Chest discomfort or pain is sometimes present, especially when taking deep breaths or coughing.
• Fatigue or low stamina caused by reduced oxygen levels to the body.
• Unintentional weight loss.
• Swelling in the ankles, feet, or legs, which can be linked to chronic lung disease, pulmonary hypertension, or heart and lung complications. 

Seek medical attention right away if you cough up blood, develop persistent hoarseness, or have an unexplained fever. Recognizing these symptoms early and discussing them with a healthcare provider can help lead to a faster diagnosis and more effective treatment.

What Are the Most Common Types of Lung Disease? 

Lung diseases are conditions that affect the function and structure of the respiratory system. The most common types of lung diseases are:

• Chronic obstructive pulmonary disease (COPD): COPD includes emphysema and chronic bronchitis. It is one of the most common lung diseases and is often linked to smoking or long-term exposure to air pollution and other irritants.
• Pulmonary hypertension: This condition occurs when blood pressure in the arteries of the lungs become too high. It can make it harder to pump blood and lead to serious complications if left untreated.
• Pulmonary embolism: A pulmonary embolism is a serious condition that happens when a blood clot, usually from the veins in legs or the pelvis, travels to the lungs and blocks blood flow. 

Preparing for Your First Appointment at the Center for Advanced Lung Care 

Preparing ahead of time for your first appointment at the Center for Advanced Lung Care can help you make the most out of your visit. Before you arrive, gather any medical records related to your lung health, including previous test results, imaging scans, and a list of all of your current medications. It is also helpful to write down your symptoms, when they started, how often they happen, and anything that makes them better or worse. This information can help the care team better understand your condition.

You should be ready to discuss your personal and family medical history, since some lung and pulmonary diseases may be linked to genetic and environmental factors. Bringing a list of specific questions or concerns can help you have a meaningful discussion with your pulmonologist and better understand your diagnosis, testing options, and treatment plan.