May 20, 2003

Removing a portion of the diseased lungs of patients with severe emphysema can somewhat improve their capacity to exercise and their overall quality of life, according to a much-anticipated study released today by the New England Journal of Medicine. In theory, surgery to remove diseased portions of the lungs allows healthy portions of the lung to expand, increasing gas exchange and improving patients’ ability to breathe, according to Robert Cerfolio, M.D., chief of thoracic surgery at the University of Alabama at Birmingham and one of the reviewers of the study. However, Cerfolio says the study shows the procedure is only beneficial in a particular subset of patients, particularly those with disease limited to the upper lobes of the lungs.

For patients who suffer from emphysema, Cerfolio says several steps should be taken to determine if they are eligible. “First and foremost, you must be smoke-free. In order to qualify, you have to be off cigarettes for at least six months, and preferably nine months,” he said. Patients should then talk to their primary care physician, he says. “There are some relatively cheap screening tests a primary care physician can perform to determine eligibility.” Some of these tests include a blood-gas test, a pulmonary function test, and a chest CAT scan to determine if the emphysema is contained in the upper lobes of the lungs. In addition, a patient can not be on high doses of steroids, which is often one of the medical therapies used to treat emphysema.

In order to qualify, patients must:

• Be smoke free for at least 6 to 9 months;
  
  
• Not be on high doses of steroids;
  
  
• Be screened by a primary care physician with tests that include a blood-gas test, a pulmonary function test and a chest CAT scan;
  
  
• Have emphysema contained in the upper lobes of the lungs.

B-roll of Cerfolio in surgery, along with interview sound bites illustrating the points above, is available from UAB Media Relations.