The first step that must be taken by any person with emphysema is to stop smoking, if they have not done so already.
Patients must then be aware of the fact that most emphysema treatments focus on improving quality of life: there is no cure for emphysema. The closest thing to a cure is lung transplantation. Nevertheless, many treatments produce excellent results, and patients are able to resume many of the key activities of daily living.
In addition, any and all treatments must be combined with a pulmonary rehabilitation program. In these programs, people with emphysema receive important information to help them learn to live with the disease. They also receive exercise training and learn about other ways to continue to lead an active life.
Surgical Treatment Options
Lung volume reduction surgery
This procedure removes some diseased parts of the lung, helping the healthy lung work better. It is a very complex surgical procedure, and many people with emphysema are too weak to withstand it. Another surgery, called a bullectomy, removes some of the bubbles formed by destruction of the alveoli, improving breathing.
Transplantation
Lung transplant can be an alternative in severe cases of emphysema.
Nonsurgical (minimally invasive) therapy
A “minimally invasive” procedure is one that requires no cuts or stitches, unlike ordinary surgery, and is performed under simpler types of anesthesia than regular surgery.
As lung volume reduction surgery is an extremely aggressive procedure and no medications are able to cure emphysema, a lot of the research conducted in recent years has focused on minimally invasive treatment.
Thus far, the most highly developed minimally invasive treatment involves the placement of devices called bronchial valves. Two types of valves have been developed by U.S. scientists:
One-way endobronchial valve
This is the treatment modality offered by the Hospital Moinhos de Vento Emphysema Treatment Group. This little valve is inserted into the airway with the aid of a bronchoscope. The purpose of the valve is to let air out of the diseased part of the lung, while preventing air from entering the damaged alveoli. This helps air circulate through the healthy part of the lung instead, producing a substantial improvement in breathing capacity. Our valves are manufactured by Pulmonx a U.S.-based company.
Not all patients will improve with use of these valves. Therefore, treatment candidates will undergo a series of tests prior to the procedure. If our team decides that valves can help, the patient will be admitted to the hospital for the actual procedure, which is performed under sedation and takes approximately 30 minutes. Although valve placement is straightforward and very brief, the patient still has to stay in the hospital so our doctors can control his or her reactions to the procedure.
Spiration
Another type of valve is being manufactured by a U.S. company by the name of Spiration. The shape of the Spiration valve is somewhat different from that of the valves used at HMV, but the underlying principle of operation is identical.
The Spiration valve is still an investigational product and, therefore, cannot be used routinely in the hospital setting just yet.