London: A blast of steam that scalds the lungs may provide relief to patients with breathing disorders such as emphysema. New research shows that the 30-minute procedure can improve lung function and reduce breathlessness — as a result patients are also able to exercise more easily.
Up to two million Britons suffer from breathing disorders such as emphysema — these disorders fall under the umbrella term chronic obstructive pulmonary disease (COPD).
Healthy lungs contain hundreds of millions of tiny air sacs called alveoli, which help in the absorption of oxygen into the blood as well as removing carbon dioxide.
In emphysema patients, these tiny air sacs become inflamed, and in many cases are damaged and destroyed, triggering coughing and breathlessness. This is frequently due to the effects of smoking, but the condition can also affect non-smokers — either through a genetic susceptibility, or exposure to workplace chemicals.
In more severe cases, surgery is used to remove the worst affected parts, cutting the size of the lungs. This reduces the strain on the organ because the air is inhaled into a smaller space, making breathing easier. However, many people with the disease are not generally well enough to undergo such extensive surgery, and hospital stays can last up to two weeks.
The new therapy, developed by U.S.-based Uptake Medical, also reduces the volume of the lungs, but uses steam, rather than surgery, in a procedure that requires just an overnight stay in hospital. First the lungs are scanned to identify the dysfunctional areas. An endoscope or tube is then inserted into the lungs through the airway.
A small balloon is fed down this tube and inflated in the lungs to block off the area being treated, so that steam does not flow backwards into healthy parts of the lung. Then steam is fired through the tube into the targeted lung tissue, scalding the tissue. Each vapour blast lasts between three and ten seconds.
Over the following weeks, scar tissue forms which shrinks the tissue — in the same way that a scar pulls the skin around a wound tight. This reduces the volume of the lungs, making breathing easier.
Results from international trials of more than 50 patients show the therapy leads to significant improvements in lung function (measured as a reduction in breathlessness), and increases the amount of physical activity they could perform, which was gauged by the distance they could walk in six minutes. There were also improvements in overall quality of life.
Dr Felix Herth, head of Pulmonary Medicine at the University of Heidelberg, Germany, who led one of the studies, said: ‘A procedure that shows an 83 per cent improvement when looking at several end points [such as lung capacity and level of physical activity] should provide new optimism for patients who are living with emphysema.’
The treatment has recently been approved for use in the UK and Europe and in the past few weeks has been used to treat patients in Germany. It is not currently available in the UK.
Commenting on the research, Professor Michael Polkey, consultant physician at Royal Brompton & Harefield NHS Foundation Trust, said: ‘This latest research avoids the need for surgery, which can mean patients suffer less discomfort and recover more quickly.
‘At Royal Brompton we carried out the first UK clinical trial of lung volume reduction surgery which is now a widely-accepted therapy for selected patients and the outcomes are extremely good. We are also planning further studies using non-invasive techniques.’
Dame Helena Shovelton, chief executive of the British Lung Foundation, added: ‘Using steam is a developing area, but there is insufficient evidence about the benefits at the moment. We look forward to seeing more clinical trial results.’
# Source: The Daily Mail, By Roger Dobson
