AKRON, Ohio — It doesn’t seem logical that shrinking or removing part of the lung would help someone with emphysema breathe better.
But the treatment — known as lung volume reduction surgery — has been shown to work in certain patients.
For Kent, Ohio, resident Adina Mather, though, the treatment would have required full-fledged, sternum-splitting surgery. She considered it, then dragged her feet and finally “chickened out.’’
She’s glad she did. Since considering the surgery in mid-2006, there has been an alternative. A nonsurgical, though experimental, form of lung volume reduction is in clinical trials.
Instead of surgically removing up to 30 percent of the most diseased areas of the lungs, the new technique — called biologic lung volume reduction — uses a flexible tube to deliver a gel to areas of the lungs. Over four to six weeks, this gel causes scarring and shrinking of the lung tissue.
Emphysema is a form of chronic obstructive pulmonary disorder in which the air sacs (or alveoli) in the lungs are damaged, depriving the body of oxygen.
Dr. Sanjiv Tewari, director of the Center for Advanced Lung Diseases at Akron General Medical Center, said that in emphysema patients, the lungs essentially become too big for the abdomen, placing pressure on the diaphragm and making deep breathing difficult. The theory is that by reducing the size of the lungs, the remaining healthy tissue will have more room to expand, as will the diaphragm.
Mather, 60, underwent the new procedure last month at Akron General, one of two hospitals in Ohio and eight in the nation taking part in the clinical trials.
Even though doctors told her it’s still a little early for her to notice a difference, Mather thinks she has.
“I can walk a little farther than I could before,’’ she said. “I don’t get as short of breath as quickly.’’
It’s a start, said Mather, a smoker of 35 years, but “I’d like to feel even better.’’ She’d also like to lessen her reliance on oxygen and improve her quality of life.
Mather initially was treated with an inhaler and medication, along with pulmonary rehabilitation.
“I couldn’t even get on a treadmill at that point,’’ she said. “That’s how bad I was.’’
Her pulmonologist at Robinson Memorial Hospital suggested that she pursue a lung transplant at the Cleveland Clinic. But the Clinic doctor suggested lung volume reduction surgery, which sounded like a better option to Mather because it was less invasive and she could always choose a transplant later if it was still necessary.
Still, she “chickened out,’’ and delayed the surgery.
In the meantime, she searched Internet chat rooms and found talk about the nonsurgical procedure.
Again, though, Mather had reservations.
“One of the reasons was that this isn’t proven yet,’’ she said. “We don’t know what the side effects are. This is really new. This is a clinical trial. The purpose is to determine safety and efficacy.’’
Tewari also pointed out that the procedure is new and unproved.
Asked how well the procedure works, he said — “It’s too soon to tell.’’ It’s the purpose of the trial to find that out.
However, he added, “there’s a good theoretical argument as to why this would help patients.’’
The theory is based largely on the outcome of surgical lung volume reduction.
The National Emphysema Treatment Trial found that lung volume reduction surgery helped most in those with severe emphysema in the upper lobes of the lung who did not respond to rehabilitation. However, that trial also showed that patients at high risk for surgery and those with emphysema in other parts of the lung had the least benefit and could even be harmed, according to the American Lung Association.