Emphysema on CT scan – What is my prognosis?

What is my outlook for emphysema?

Dear Dr. Mahler:

I am 43 year old female who was diagnosed with chest ct mild emphysema. 3 years ago my pft was in normal range. I have since then quit smoking and gained a lot of weight. Also, I suffer from anxiety and I am terrified I will progress to end stage. I do not have the alpha tripsan defiency. Everything I read is doom and gloom and I feel as though Im doomed. I currently use symbicort 2x a day and albuterol as needed. Any advice would be greatly appreciated.

Val from Portland, OR

Dear Val:

You have a somewhat unique situation  You have emphysema on the CT scan of your chest, but normal breathing tests (PFTs). This generally indicates that your past cigarette smoking caused damage to your air sacs (alveoli), but

Microscopic view of the air sacs (alveoli) in the top right showing emphysema (destruction and enlargement).

Microscopic view of the air sacs (alveoli) in the top right showing emphysema (destruction and enlargement).

there is no narrowing or obstruction of your breathing tubes (airways). Remember that emphysema is one of two types of COPD – the other type is chronic bronchitis (coughing up mucus most days).

CT scan shows emphysema in the left lung. Arrows show "dark" areas in periphery of the lung with no blood vessels due to emphysema.

CT scan shows emphysema in the left lung. Arrows show “dark” areas in periphery of the lung with no blood vessels due to emphysema.

You wrote that everything that you read about emphysema is “doom and gloom.”

However, that is quite unlikely in your case as you quit smoking. As long as you don’t smoke, you should not have further damage to your lungs.

It is common that many people gain weight when they quit smoking. I encourage you to start an exercise program either on your own (walking daily) or join a community health and fitness center. I don’t believe that you qualify for pulmonary rehabilitation as your breathing tests are normal.

Finally, I encourage you to think positively because your condition should not get worse as long as you don’t smoke and don’t inhale irritants in the air.

Best wishes,

Donald A. Mahler, M.D.