In advanced emphysema, the lungs’ air sacs are severely damaged, resulting in persistent shortness of breath and reduced quality of life.

Emphysema is a type of chronic obstructive pulmonary disease (COPD) characterized by damage to the air sacs (alveoli) in the lungs.

Emphysema is generally classified as “advanced” when your ability to exhale is less than 50% of the expected or predicted level.

Advanced emphysema can cause symptoms that significantly affect your daily life, such as severe shortness of breath, even with minimal exertion and reduced exercise.

Advanced emphysema is a severe type of chronic obstructive pulmonary disease (COPD) in which the air sacs (alveoli) in the lungs lose their elasticity, causing severe damage.

The damaged alveoli make it challenging to exhale properly, leading to the accumulation of stale air. This can cause your lungs to expand and result in significant shortness of breath. Everyday activities like walking short distances, climbing stairs, or simply having a conversation may leave you feeling breathless.

Signs and symptoms of advanced emphysema

The signs and symptoms of advanced emphysema can vary among individuals, but common manifestations include:

  • severe shortness of breath
  • chronic cough
  • wheezing
  • fatigue
  • rapid breathing
  • chest tightness

Emphysema is classified into three stages, which reflect the severity of lung dysfunction. The stages include mild, moderate, and severe. The severe stage is the final stage of emphysema.

During the severe stage, the loss of elasticity in the lungs’ air sacs leads to overexpansion and the trapping of “old” air. This results in hyperinflation, where the lungs become larger and make it difficult to exhale effectively.

Hyperinflation contributes to severe shortness of breath and can significantly affect your quality of life. This includes no longer being able to go to work or do chores around the house. It also likely means having trouble walking upstairs or even crossing a room.

Additionally, the risk of respiratory failure is high, and you may need supplemental oxygen and possibly mechanical ventilation to support your breathing.

In general, the progression of emphysema is a slow and gradual process that takes several years to advance through the stages.

However, your rate of progression can be influenced by various factors, including your health, smoking history, exposure to lung irritants, and genetic predisposition.

The diagnosis of advanced emphysema typically involves a combination of medical history, physical examination, lung function tests, and imaging studies.

Here are some common diagnostic procedures:

  • Spirometry: Spirometry is a common lung function test that measures the amount of air you can forcefully exhale and how quickly you can do it. This helps assess the severity of airflow limitation and determine the stage of emphysema.
  • Diffusion capacity: This test evaluates your lungs’ ability to transfer oxygen from inhaled air into the bloodstream. It measures how efficiently gasses pass through the alveoli and the thickness of the lung’s membrane.
  • Imaging studies: Chest X-rays and CT scans are imaging tests that show detailed pictures of the lungs. These images help doctors see any structural changes in the lungs caused by emphysema, such as larger air spaces or damage to lung tissue.
  • Arterial blood gas analysis: This test measures the oxygen and carbon dioxide levels in your blood, helping assess the efficiency of gas exchange in the lungs.

The treatment of advanced emphysema aims to relieve symptoms, slow disease progression, and improve overall quality of life.

While there’s no cure for emphysema, several treatment options are available:

  • Quitting smoking: Quitting smoking is crucial in managing emphysema and slowing disease progression. Most people with COPD have a history of smoking. In fact, one 2016 study involving people with COPD found that only 27.2% of female participants and 7.3% of male participants with COPD had never smoked.
  • Medications: Bronchodilators, such as short-acting or long-acting inhalers, help relax the airway muscles, making breathing easier. Corticosteroids may also be prescribed to reduce airway inflammation.
  • Oxygen therapy: Supplemental oxygen is often prescribed to increase oxygen levels in the blood and alleviate shortness of breath. It may be used during physical activity or continuously, depending on your severity.
  • Pulmonary rehabilitation: This program includes exercise training, breathing exercises, and education to help improve lung function, increase exercise tolerance, and enhance overall well-being.
  • Bronchoscopic lung volume reduction (BLVR): BLVR is a minimally invasive procedure performed using a bronchoscope, a thin tube inserted through the airways. This procedure involves placing special valves or devices in specific areas of the lungs to help reduce hyperinflation and improve lung function.
  • Lung volume reduction surgery (LVRS): In LVRS, a portion of the diseased lung tissue is surgically removed, allowing the remaining healthier lung tissue to function more efficiently. Evidence shows that LVRS can specifically target and reduce the hyperinflation associated with severe emphysema.
  • Lung transplant: Lung transplantation is a surgical procedure in which a diseased lung is replaced with a healthy lung from a donor. It’s typically reserved for individuals who’ve exhausted all other treatment options and have a significantly reduced quality of life due to their emphysema.

How long can you live with advanced emphysema?

A 2021 study found that people with COPD lived, on average, 6 fewer years than those who did not have COPD.

However, the life expectancy of someone with advanced emphysema can vary depending on several factors, including the severity of the disease, the effectiveness of treatment, and individual health conditions.

For instance, the same research study found that people with COPD who were more physically active tended to have a longer life expectancy.

Advanced emphysema is a severe and debilitating form of COPD characterized by significant lung damage and impaired respiratory function. The condition significantly impacts daily life, causing severe shortness of breath and decreased quality of life.

By focusing on early detection and comprehensive care, we can strive toward better outcomes and a brighter future for those living with advanced emphysema.