Health

Emphysema Surgery Proves Effective

By CBSNews.com staff CBSNews.com staff

January 31, 2002 / 8:40 AM EST / CBS

An estimated two million people suffer from emphysema in this country, and there is good news about a new surgery to help damaged lungs to breathe easier. CBS News medical correspondent Dr. Emily Senay explains.

Emphysema is a chronic and progressive disease of the lungs usually caused by smoking. It gradually robs the patient of the ability to breathe. There is no cure and very few effective treatments.

But a new study to be presented this morning at the annual scientific and clinical meeting of the American College of Chest Physicians (ACCP) in San Francisco, shows that a new surgery called lung volume reduction surgery is safe and effective in prolonging life and improving quality of life. The basic principle is to take out the diseased part of the lungs to make it easier for the healthier parts to breathe.

Emphysema causes loss of elasticity and destruction of the tiny air sacs in the lungs, which results in severe shortness of breath.

The patient is able to breathe in air but unable to breathe it all out. As a result, the lungs become expanded, and breathing becomes even harder. Volume reduction surgery takes out the diseased, non-functional parts of the lung in order to literally create more room for the remaining lung to breathe.

How long does the surgery work for?

Dr. Senay: That's the question that a lot of doctors have been asking. This is the largest and most comprehensive study to date, measuring more than two hundred patients with severe emphysema over five years. These are patients with a life expectancy of about three years without surgery.

The study found that 70% were still alive five years after the surgery, and lung function had increased by an average of 50%.

How did it improve quality of life?

Dr. Senay: There is still deterioration of the ability to breathe over time, but more than 80% of patients said they were generally happy with the outcome of the surgery. They could walk further without running out of breath, suffered less breathlessness and needed less oxygen.

Does the surgery work for everybody?

Dr. Senay: It's been proven in many studies to work for most people. And since there's nothing better available at the moment, for those who aren't responding to other treatments it's worth a try.

Is it covered by insurance?

Dr. Senay: Most private insurance pays for it, but Medicare does not cover the operation. They are waiting for the results of a bigger study before they agree to cover it. But the latest data shows that people who don't get the surgery when they need it live shorter lives, so the issue of Medicare coverage is controversial.

What other treatments are available?

Dr. Senay: Inhaled therapies are used to open up air passageways and oxygen is often used to help with breathing. Exercise and good diet can help too.