Doctors looking at new option to treat emphysema without surgery

Right now, nearly six million people in the U.S. are having a hard time catching their breath. Severe emphysema strangles the life out of energetic people.

Traditionally, drugs, inhalers, a lung transplant or a massive surgery were the only ways to help. Now doctors are testing a new option with no surgery needed.

Shasta the Sheltie is all dolled up and ready to go. For the first time in a decade, Shasta's owner can go, too.

Advanced emphysema had a chokehold on Pam Taylor's life.

"At my worst point, I was ready to lay down and die,” Pam Taylor said.

She tried inhalers, meds, therapy and oxygen.

"Your breath is gone, just gone, and the worst part is you never know when or if it's coming back,” Pam said.

Now, doctors say a tiny valve may be the answer to Pam's problem.

"If this works, this is going to revolutionize how we take care of advanced emphysema,” Dr. D. Kyle Hogarth Assistant Professor of Medicine at the University of Chicago Medical Center said.

Traditionally, for severe emphysema, the options were lung transplant or a massive surgery to cut out the bad parts of the lung. In a new procedure, doctors place umbrella like bronchial valves in the airway. They redirect airflow away from the diseased regions of the lung and toward the healthy parts.

"If you could sort of shut those regions down, you would allow the good lungs, the regions of the lung to do more work. It's clearly a lot easier to put a device in the airway than it is to have your chest cut open,” Dr. Hogarth said.

Six months after her valves were put in, Pam put away her oxygen and easily keeps up with Shasta's pace.

"This helped me so much,” Pam said.

In a European trial, experts found the valves were safe to use and improved quality of life. The bronchial valves are in the final phase of testing in the U.S.

People enrolled in the trial who get a sham valve are eligible to have the real thing implanted after six months.

Doctors say the treatment is best for those who have emphysema in the upper parts of their lungs, not the lower parts.

BREATHING EASIER WITH EMPHYSEMA

BACKGROUND: Emphysema is one of the stages in the progression of chronic obstructive pulmonary disease (COPD). It's a condition that limits the flow of air when you breathe out. Emphysema occurs when the air sacs at the ends of the smallest air passages are gradually destroyed. Smoking is the leading cause of emphysema. Emphysema is an irreversible, end-stage process that progresses slowly over many years. Currently, there is no cure. It's estimated nearly 4 million people in the U.S. have emphysema. Of those, more than half are men, and about 45 percent are women. The primary symptoms of emphysema include shortness of breath, rapid breathing, wheezing, chronic cough and loss of appetite.

TREATMENTS: Doctors say the most important step in any treatment plan for smokers with emphysema is to stop smoking; it's the only way to stop the damage to the lungs from becoming worse. Other emphysema treatments focus on slowing the progression of the disease. Bronchodilators are drugs that can help relieve coughing, shortness of breath and can relax constricted airways. Corticosteroid drugs can also be inhaled as aerosol sprays and may relieve symptoms. However, prolonged use can weaken bones and increase high blood pressure, cataracts and diabetes risk. Many patients with severe emphysema rely on supplemental oxygen or take part in a pulmonary rehab program, which combines education, exercise and behavioral intervention to help patients stay active. Finally, surgery and lung transplant are also two options for people with severe disease. The lung reduction surgery is where surgeons literally cut out the diseased parts of the lung, with the hopes of helping the lungs work more efficiently and make breathing easier.

NEW TRIAL: Doctors around the country are testing an investigational device that may help those with emphysema lead a more normal life. It's called the IBV Valve System. It does not require surgery. Instead, tiny valves are placed in the lungs during a bronchoscopy while the patient is sedated. The valves are meant to redirect the airflow in the lungs away from the diseased parts and toward the healthier areas, leading to an overall improvement in breathing. "When it's put inside the airways, it [the valve} expands open and sort of seals the airway to prevent more air from going into the bad region of the lung. But when people are breathing out, it closes down a little bit so that air can come out and so that secretions in the lung can also come out," D. Kyle Hogarth, M.D., of the University of Chicago Medical Center, told Ivanhoe. "It's clearly a lot easier to put a device in the airway than it is to have your chest cut open. If this works, this is going to revolutionize how we take care of advanced emphysema," said Dr. Hogarth.

FOR MORE INFORMATION, PLEASE CONTACT:
John Easton, Director of Communications
University of Chicago Medical Center
Chicago, IL
(773) 702-6241
John.easton@uchospitals.edu


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