DEAR DR. DONOHUE: I was recently diagnosed with pulmonary fibrosis. It showed in 2003. I had no knowledge of it.

My doctor said she heard rattles in my lung and ordered further tests. A lung specialist had a CT scan done, and it confirmed the diagnosis.

I am 68 and have never smoked. Would you address this disease? The doctor says there is no cure. I am very frightened. My brother died from it two years ago. – J.B.

ANSWER: Pulmonary fibrosis is lung scarring. Strands of scar tissue crowd the spaces between the lungs’ millions of air sacs.

This is something that can happen with a variety of diseases, like rare pneumonias, sarcoidosis, rheumatoid arthritis, scleroderma and exposure to things like silica and asbestos.

However, many times, a cause cannot be found, and the illness is called idiopathic (cause unknown) pulmonary fibrosis. Your brother having had it suggests a genetic basis, and that’s the case in some instances.

As scar tissue fills the lungs, symptoms gradually appear. The two prominent ones are shortness of breath on slight exertion and a dry cough.

How fast the condition progresses is something that cannot always be predicted. You have had it for more than four years and are getting around without a great deal of difficulty. That’s a good sign.

High-resolution lung scans provide compelling evidence of pulmonary fibrosis.

Sometimes the only way to make a definite diagnosis is to obtain a small piece of lung tissue for microscopic examination.

There is no cure medicine, but there are treatments. For one, supplemental oxygen makes it easier for pulmonary fibrosis patients to move about.

A second treatment is a combination of the cortisone drug prednisone with either azathioprine or cyclophosphamide. This treatment has its pros and cons, and the patient has major input about embarking on it.

In those younger than 60, lung transplantation is an option.

DEAR DR. DONOHUE: We are told that our 11-year-old son has a varicocele on his left testicle. The urologist told us to watch it for changes and said that surgery might be necessary. The boy has no symptoms. We are concerned that it may affect his fertility. What are the chances it will affect his fertility?

He plays a lot of sports and doesn’t like the way it makes him look different. – L.S.

ANSWER: About 15 percent of men have a varicocele, and of that 15 percent, 15 percent are subfertile. Looked at in a different light, 85 percent are fertile.

A varicocele is a dilated and entangled ball of veins within the scrotum. Most of the time, it causes no symptoms. In a small percentage, it can affect fertility.

One functioning testicle, more often than not, permits a man to father a child.

Varicoceles should be removed if the unaffected testicle is much smaller in size than the testicle with the varicocele, if the unaffected testicle has any disorder or condition that could disturb fertility, or if the varicocele enlarges.

The procedure usually can be done on an outpatient basis and often with a scope.

DEAR DR. DONOHUE: You recently said that people with dementia do not die of it but from other causes, often due to malnutrition.

My mother had serious dementia and passed away last month after being on dialysis for two years. She lived with me for 16 years, and I prepared all her meals. Her nutrition was well-balanced. – C.B.

ANSWER: I did not mean to imply that caregivers were responsible for an Alzheimer’s patient’s malnutrition. Some Alzheimer’s patients lose all interest in food and stop eating.

Many patients die from causes other than Alzheimer’s disease – the same things that cause other people’s death: kidney failure, heart attacks and strokes, none of which are directly related to Alzheimer’s.

The booklet on Alzheimer’s presents the details of this epidemic illness.

Readers can obtain a copy by writing: Dr. Donohue – No. 903, Box 536475, Orlando, FL 32853-6475.

Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com