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March 2nd, 2010
11:50 AM ET
Asthma advancesBy Saundra Young 23 million Americans, 7 million of those children, struggle with asthma. The statistics are sobering. Every day in the United States, 30,000 people have an asthma attack. 40,000 miss school or work because of the disease, emergency rooms see 5,000 asthma patients; 1,000 of those will actually be admitted to the hospital and 11 people will die. Every day. It's one of the country's most common, and most costly diseases. During an asthma attack the smooth muscle around your trachea, or windpipe, constricts, squeezing down and causing shortness of breath and chest tightness. There is no cure for this chronic disease, and for those who suffer with severe, persistent, debilitating asthma, quality of life can be downright miserable. Treatment has been limited to medications that are often short lived and can potentially have side effects. But according to Dr. Mario Castro, a pulmonologist at Washington University School of Medicine in St. Louis, Missouri, a breakthrough is close at hand. Castro led a clinical trial testing the first ever non-drug treatment for severe asthma. It's called bronchial thermoplasty and he contends that it actually prevents attacks (watch Dr. Sanjay Gupta's report here). "What bronchial thermoplasty does is it allows us to go down into your windpipes, into your bronchial tubes and deliver a very controlled energy, a controlled heat to the lining of your windpipe," Castro said, "What it results in is that the muscle, the smooth muscle around your windpipe is decreased in the amount and size." There are three treatments, three weeks apart and no overnight hospital stay. Nearly 300 patients participated in the largest trial of it's kind here in the United States. Those who actually got the treatment logged 84 percent fewer visits to the emergency room than the patients who didn't. Jenny and Michael McLeland, severe asthma sufferers their entire lives, were both got the thermoplasty. Both of us experienced a huge change in our asthma symptoms." Jenny said. "The summer following our treatments we did RAGBRAI, which is a weeklong bike ride up in Iowa. So it involved biking about 550 miles and camping over an entire weekend. Prior to the treatment I couldn't sleep outside. I couldn't sit in the grass without getting wheezy. So to be able to make it through an entire week with no problems was just phenomenal." Two and a half years after the treatment, Jenny hasn't had to make a single visit to the ER. And Michael says he can't put a price on his new-found quality of life. "I feel like I'm 18, 19 years old and doing anything, it feels like I can do anything I want to now. I've done things that I didn't think I would be able to do. The quality of life– the expenses I don't have to worry about anymore, just kind of the emergency room costs and the physician costs and the medication was expensive." Dr. Norman Edelman, chief medical officer of the American Lung Association, says anything new that will help these patients is an important advance. "It's a new concept. Nobody up until now has thought of dealing with asthma by changing the anatomy of the lung.' But Edelman cautions there is a downside. "It's a complex procedure. Local physicians who treat asthma will not be ready to use the technique." An FDA advisory committee has already recommended approval on several conditions—such as doctors getting the proper training and requiring that the procedure be performed only at a facility with full resuscitation equipment. The FDA is still considering the recommendation. So, if you're on the highest dose of your asthma medication and feeling like there's no where else to go, help could be just around the corner. Editor's Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation. |
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
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Let me cast a shadow of doubt over the concept of Bronchial Thermoplasty,Why?
Like anything that is a "Quick Fix",I am concernd about the long term
effects.I am also unhappy with a local treatment that does not adress
to the general,whole organism.
What do I suggest:Treat the whole person,Treat the Metabolic Syndrome.If you are not in the clear,what am I talking about,write
me,(or you Academic institute).I will be happy to discuss.
It's about time they finally make some promising advances in Asthma treatment! We have been relying on rescue inhalers for far too long.. The down side to using an inhaler is that it can often become addictive – even to the point where one has to rely on it to breathe 'normally'! Not to mention the fact that relying on inhaled steroids cannot be a healthy habit to begin with.. Bring this to the masses!!
This sounds wonderful!! I've had asthma now for 60 years and it dictates just about every aspect of my life. This sounds like a fabulous new approach that works without the additon of the myriad medications that most of us asthmatics are on. Please let us know when this will be available.
Would this be an effective treatment for COPD?
As an asthma sufferer for 25 years now, I cant even tell you how thrilled I'd be to be able to use this technique to deal my asthma more effectively.
Where do I sign up!!!!!??? Living with asthma for the past 40 years and would love the opportunity to improve my quality of life.
I've had severe asthma since a child. Singulair, Advaire, etc. have unhealthy side effects. Before trying surgery, try boswellia. I keep my weight under control, avoid allergen such as wheat, eat plenty of broccoli and use boswellia which inhibits the enzyme (5-Lipoxygenase) that causes inflammation.
This makes me wonder about long term side effects or complications. Would changing the anatomy of the bronchial tubes make people more susceptible to bronchitis or other similar illnesses?
If not, and it is proven safe, then sign me up. I've had asthma since I was a child and even though my asthma is considered moderate it essentially determines where I can live and what I can do. I would be very glad to breathe freely once again... assuming I can afford the procedure.
No, this would not be a treatment option for COPD, as the disease process is completely different from that in Asthma.
Has this treatment been tested on pediatric patients? With growing airways, I'm curious if the same results will be achieved.
-www.theasthmaadvocate.com
As an asthma sufferer for all of my life and having a father with the same hereditary ailment, "rescue inhalers" are NOT the answer- you need to control the disease, not just the symptoms. Steroid inhalers such as Advair and Sympicort work wonders if taken every day. Rescue inhalers should not be used as treatment. Unfortunately, some of the maintenance inhalers like Advair are not affordable without insurance. Also, Singulair, a pill, is also effective and has no side effects. As far as side effets from Advair, I'm not sure what they are and I've been on Advair for over ten years. I am a little confused as to how this therapy works as your bonchial tubes are located in your lungs, AND it is my understanding that an asthma attack is caused when your bronchial tubes are so inflamed, it is constricting breathing. Am I correct?
I was on four asthma medications and got rid of three by using the Buteyko Method. It's a re-breathing technique that I do daily and it's totally natural! This process can be used for COPD.
this will last 5 seconds because the big pharma doesnt want a cure to such a thing as asthma,who would buy asthma meds??? Our government and probably fda is bought and sold!!
jonnyrottin you are probably correct.Something like this could devistate their bottom line.It's all about greed,to hell with the asthma suffers "we are getting rich".
something to keep an eye on....
There is also an overwhelming amount of research about the effectiveness of chiropractic care with regards to asthma. This is also a drugless approach and is much less evasive than the above procedure. Patients have been able to get off of all meds while under regular chiropractic care.
First commenter: Is there a tie between asthma and Metabolic Syndrome?
More b.s from the pulmonary specialists who want to safe guard their incredibly greedy incomes. There is a method out there to treat asthma where you don't have to go near the medical fraternity or the drug companies. It's called the Buteyko Method, developed by a Russian doctor, Dr Buteyko over a 50 year period. I've had asthma for over 60 years. I took the Buteyko course (plenty of videos on YouTube including those in the US greedy medical profession who try and pooh-pooh the method.) You don't need drugs. You don't need a gouging pulmomary "specialist" and you don't need to get ripped off by the legal drug peddlers in the pharma industry. I no longer need my emergency inhaler which I was using three times a DAY. The Buteyko method was written about in the New York Times a few months ago. It should be on "60 minutes" but you can guarantee it will not be if they show ads paid for by the corrupt US drug business. Go onto YouTube and put "Buteyko" in the search box. Then sit back and be amazed.
Wash U in St Louis does some marvelous research and has helped so many. They are definitely the Harvard of the Midwest. Congrats again to help those in need.
Breathing Exercise substantiall reduces the Asthma Attack. I had been practising the same for 3 yrs and the no of attacks had decreased substantially.
Check your Vitamin D levels as well. Most people are deficient in vitamin D. There is a lot of preliminary evidence that low vitamin D levels contribute to asthma problems, and increasing your intake (and blood levels) of D can greatly reduce the severity and frequency of attacks.
This sounds incredibly promising - I just hope they make it available and affordable to everyone who needs it. I've been taking Asmanex for awhile now (and several other meds before that); it's over $100 for a 30 day supply and that's WITH insurance. My doctor actually prescribed that I take that 2x a day during allergy season b/c my symptoms get so out of hand, but I can't pay over $200 a month for medications. Add to that that noboby wants to take medication everyday if they don't have to and this new treatment sounds really great. I'm all for a non-drug treatment that prevents symptoms. I'd love to eliminate the cost and the jitters that come w/ asthma meds!!! Like others said, though, I worry that noboby would fund this, and if they do it would be incredibly expensive. Plus I wonder if any insurance companies would cover this cost - would it be considered medically "necessary" if daily meds are still available?
I keep wondering what's taking the medical community to catch up to the systemic mechanism behind asthma. I've had asthma since I was a kid. Went on the alupent short-acting puffer. Made my heart race. Also did the ephedrine and theophylline pills. Made my heart race worse. Did the steroid puffers. First steroid puffer gave me asthma, but later they seemed to help. But the asthma got worse progressively until I got allergy shots, and that helped. Then one day I took Klonopin (a sedative) for another problem, and my asthma was gone! Amazing! It was a ray of hope, that I wasn't locked into the classic treat-the-cause prison of inhalers and bronco-stimulants. Tried anti-depressants next, and wow! They also got rid of the asthma. But now I'm trying low-dose naltrexone, and that gets rid of my asthma too. Anyone willing to do studies on why these help? Didn't think so.
Hope they can do this for animals as well as human animals one day. One of my cats has asthma. We manage it with prednisone, turbutaline , and two different inhalers. One inhaler for daily use and one for acute attacks. We use air purifies to minimize dust and pollen etc. She is the sweetest creature and it would be so wonderful to be able to ditch all the medications after a sucessful treatment like this.
I've had asthma for 67 years, since I was 2 years old. I can't remember not having it. Its a permanent part of my life. If this works, and I can affored it, sign me up.
I have to tell you that if given the opportunity I'd go to St. Louis and let Dr. Casro do his thing. However, I"m a bit of a complicated asthmatic. I was endowed with the whole package – severe allergies to foods, drugs and environmentals and the icing on the cake is the fact that I've been steroid dependant (oral low dose now and symbicort) for the last 44 years. I'm also maintained on theophylline. My concern would be coming off the steroids if the asthmas was cured. How would that work particularly since we don't know if my adrenal glands have shut down. My family would certainly assist me financially if this procedure is that promising. The other benefit to me is getting all of these MD' and pharmacists out of my pocket. Needless to say my asthma is well controlled despite the severity of it – as long as I take my meds daily. I would love to cut the amount of medication I take to at least half.
My medical expenses are such that I can generally do a tax write off annually. From a wholistic perspective it would be nice to not hve to put all of these toxins in my body. Yes, they serve their purpose but at a great price. Plus as new meds come out they are costlier. I have a great asthma MD who I see every 1-3 months. IHe has gotten me to where I am now. I plan to get his opinion on this treatment
Anything is welcomed because when you can't breath nothing else matters.
I have been a chronic asthma sufferer for almost 40 years. Two years ago I started taking an anti-inflammatory vitamin called Quikflex. It changed my life. I now only use an inhaler just before i work out. I used to take at least 12 puffs a day. I take two vitamins in the morning, and I am good all day. onesourceenergy@shaw.ca
This is great news. To not have to worry if I will have enough money to have a script filled vs. something like this. Since I am not seeing input from insurance providers or pharmaceutical companies, and the FDA is approving it, it must not be too safe.
Let's be careful – and honest. "Thermoplasty" is another word for cooking. The heat is applied to alter the muscles of your windpipe just as you alter the muscle tissue in a steak – not as drastically but that's what's going on.
These sort of heat treatments are very popular with surgeons and have come and go in various fields of medicine. The evidence for their benefits is usually of the lowest form and if you read these studies the same is true here. Why? Because this is a treatment based upon a Medical Device and in the US Devices undergo only a small fraction of the scrutiny a drug or biological therapy would have to. Hence they are cheap to make, quick to market and amazingly profitable!
Remember when Thermoplasty was being touted as a cure for apnea? Just look thru the medical news from a couple of years ago. What happened to that 'breakthru'? It turned out that despite the attention getting headlines it didn't work – but it did lead to scarring and enhanced bank accounts. Not the Patient's of course!
The classic example of this kind of 'directed energy' device is lithotrypsy. When it was new the manufacturer of the device touted it as an instant cure for all kidney stones. Every US hospital rushed to by one and then Urologists rushed to fill them with every Patient they could find. This went on for years until a Canadian study proved it was actually harmful for all but a small sub-set of patients. Now, only those few patients are to be found inside a lithotriptor machine. Guess where all those unused machines are now? Why being touted as a cure all for plantar faceitis (aka 'heel spurs'). There are no prospective, blinded, randomized studies to show this works, and the only studies even near to that quality show they do nothing, but the FDA lets the manufacturers and Podiatrists hawk them to trusting patients nonetheless.
I counsel caution on this one. It sounds like an old song being played on a different instrument, and the melody didn't sounded good in the past!
@ jonnyrottin
You would be correct sir. Our government and fda have in fact been bought and sold for decades now. Just look to the lobbyists.
This treatment will probably never make it out in a mass level, but it may just stay in at a treatment that you'd have to go to a specialist for. Not only that, but consider the bills for the treatment and the trip to go and see the specialist in the first place. They will be perfectly willing to charge anyone rediculus amounts for this treatment because of the desperation and the fact that they'll have a monopoly on the treatment. Long story short.... fat chance you'll find this affordable any time soon.
do you have a research link to this procedure, who was treated, ages and sex of participants, what trials were obtained, how many participants were treated, how were obtained and where is this procedure being done?
I suffer from asthma for many years and in my room you will find all kind of inhalers pills,treatment machines for emergency when I was home (I work for a hospital here in NJ) I" took all kind of treatments like onions with honey,even marijuana tea, but every day I was feeling worst and worst, I'm from Costa Rica and my mother told me that there is a Homeophatic "doctor" and people is getting good results with this treatments,well I went to Costa Rica and went to him and the medicine was little bottles and some little pills I was suppose to take 15 drops at 6am 12md and 6pm he told me not to stop my regular asthma medications until I start feeling better by the first month that I was taking this medicine I have no more astma attacks and he told me to do the same treatment for another month without my inhalers and the rest of the medicine that I was taking and now 10 years later no asthma attacks no more allergies because I 'd have all kind of allergies :peanutes,strawberries,chesse,tomatoes,dogs,cats,birds indoor
I will like to know why this kind of medications are not allow in the country I know this desease its a million dollar maker and every day we see more and more people little ones that suffer it is so sad to see them so sick and every inhaler every treatment the doctor used is no help for nobody is a "red tape" with this medicine?hopefully nobody gets better more visit to the dr.office and hospital stays?.
Did you ever made a study about Homeophatic?
thank you
eugenia fonseca
I suffer from Steroid Resistant Asthma. Past attacks have required IV steroids the bioequivalence of 400mg of Prednisone a day. Virus is my only known triggering mechanism. Would people like myself be candidates for this treatment? Thank you.
This sounds frighteningly like the "cooled thermotherapy" I had in which RF energy was used to kill off prostate cells surrounding the urethra, thereby reducing the external pressure and improving fluid flow.
I had it done, and it did work, but the side- and after effects–most notably a bladder sphincter muscle which would periodically go into spasm–were painful, troublesome and lasted up to 6 months. For this period, the cure was, indeed, worse than the figurative disease.
"Elective medical procedures" will never again be considered.
A chiropractor trying to drum up business. I have had lots of chiropractic care and despite the health benefits of chiropractic care, it does not cure alot of ailments and diseases like they want you to believe. It can help improve your overall health but people need to be aware of false claims.
I have a 5 year old son who suffers from moderate-severe asthma. I'm glad to see progress is being made, it gives me hope that someday he will have some options. There is always risk when progress is being made. It's better than doing nothing and just hoping for the best! God bless the work these people are doing.
Don't get your hopes up! The drug companies will never let anything like this succeed.
I read the article on bronchial thermoplasty, I am interested in getting more information about this procedure, and talking with my PCP about it. Is there some way I can get information mailed to my home on this procedure.
I am interested in anything that would help my asthma. I have way too long, and I am ready for something new.
Thank you
Karen Sarek
I am so glad to here of this new treatment as I am presently off on sick leave due to asthma allergic symptoms and needed some answers. My respiralogist has indicated that he was interested in sending me to a specialist in Hamilton, On, Canada for this procedure if I had qualified for it. There are some concerns because I seem to have this reactive airway whenever I come in contact with odors or smells ie., perfumes, smoke, new grass been cut, sprays and many other toxic fumes in my lungs. I am on predinsone, inhalers and singular but it does not stop the reation, as well as I seem to be dealing with all the side-effects. Can you please forward to me how the procedure works and the possible complications, Thanks
To Chris O'Grady:
"Is there a tie between Asthma and Metabolic Syndrome?"Absolutely Yes!.
Throughout our life,we are in continuous "Fight for Life".This is the
Inflammatory Process.This is the Metabolic Syndrome.
It starts with conception and ends in demise.
The most prominent/significant Disease Marker is the H.D.L.(High
Density Lipoproteins.).
The lower the H.D.L. the higher is the chanches for diseases and
demise.This happens in Asthma too.
If you wish for references,it is available by the books.
I would like to know what this proceedure cost and when and where it can be done.
My twin brother has been suffering with severe asthma his entire life. If this works, it would be an answer to my families prayers.
The results of this procedure sound great, but I have to agree with Dr.D11. This is a very new procedure, therefore the decision to undergo it should be made very carefully. The study was not a long term study, so we don't know the long term (20 or 30 years from now) side effects or consequences of this procedure. There have been many medications removed from the market years after receiving FDA approval because the medication killed people. This could also be true of medical procedures. Just this week I heard a report on the news (in passing – I didn't pay full attention to it) that the Lasik procedure to improve eyesight can cause eye problems 10 or 20-ish years later.
Additionally, every person is unique. In 2005 I underwent a medical procedure called "Novasure." I believe the generic name of the procedure is "endometrial ablation." It is used to treat heavy or constant menstrual bleeding in women who are fnished having, or don't intend to have, children. What the procedure basically does is cauterize the endometrial lining inside the uteris. It stops the bleeding, but you cannot have children after the procedure because you have no endometrial lining to which an embryo can attach. It's a beautiful thing. I have not had a period in 5 years. I love it. However...there's another side to this story.
In 1986 I was diagnosed with Interstitial Cystitis (IC). (If you don't know what it is, look it up – it's dreadful and, of course, incurable. Effective treatment options are limited. It won't kill you – it just makes you feel like you have a severe bladder infection 24/7, forever – and that could make you wish you were dead.) I struggled with the IC for several years, then it went into a sort of remission. I had no pain. I still had to urinate much more frequently than most people, but it was manageable.
Flash forward 14 years, to May 2005 – on the day I had the procedure done. The evening after undergoing the Novasure treatment, I felt like I had a bladder infection. I wondered if the surgeon had catherized me while I was under anesthesia, but he didn't say he did, nor did any of the paperwork I received indicate catherization had been perfomred. I went to the doctor, and, nope – no infection. But the bladder infection symptoms never went away. That was because the Novasure treatment had somehow traumatized my bladder just a wee bit too much and had caused my IC to come out of remission. And it was, and continues to be, much worse than it had been in 1986. Five years after the Novasure procedure I am still struggling with the IC. Because there is no cure, all the doctors can do is prescribe drugs to mask the symptoms. The amount of pills I take every day is ridiculious. Usually my ashtma ran my life – could I breath well enough to go to work? Will I come into contact with perfume or cleaning agents that will trigger an asthma flare? All of you know how that goes. But since that fateful day in May 2005, there are days when my bladder hurts so badly that it makes the asthma seem like the easy part.
I do not, emotionally, blame the doctor or the Novasure procedure for this.I don't think the doctor even knew I had IC that had been in remission for 14 years. I had forgotten about it. I do wish, however, that I had thought that out a little more. At the time of the procedure I had been bleeding every day for over a year. All I wanted was for the bleeding to stop. I didn't think about what else the procedure might cause to happen.
I would love to have this new procedure for asthma and was ready to sign up to receive it the minute I heard about it. Now, 2 days later, I think I need to wait. I need to think about this. Are there other, nearby, organs that could be damaged or undergo changes as a result of this procedure? I'm guessing that the test subjects were all healthy, aside from their asthma of course.. What might happen if you had another physical problem in that area? A heart problem, Barrett's Esophagus......(I can't think of any more examples). I suggest tlhat if this procedure becomes available and you are thinking about getting it, that you really do your homework first. Discuss it with your doctor (or doctors, if you have more than one), and research it as well as possible. Since it's a new procedure there won't be a lot of material out there to research, so you and your doctor(s) will need to make educated guesses with regard to unintended consequences such as making a currently mild or moderate condition significantly worse. I know from personal experience that unintended consequences can occur, and in my case at least, it is irreversible.
Hmm......I've almost talked myself out of this procedure.
If this treatment will provide even a possibility of relief, (PLEASE TELL ME WHO & WHERE CAN I GET IT), Please provide a contact Address, phone number.
I have suffered (severely), over 66yrs.
David
The FDA will sit on this for years. Too much money in the drugs
i've had asthma for 47 yrs now. on the highest dose of asthma drugs
how soon can i expect to wait to have this procedure,where do i go to get this done..like now
thanx
john c.
If I could afford to see this doctor and afford the procedure, I would be on the first plane or train .
I am so sick of this asthma. I am only 37yrs old! but I feel like I'm 90!! at times. I can't do simple things anymore like going out dancing or walking (for excersie) and just forget jogging. Even yoga all the things people/doctors tell me to try is like agony my lungs are screaming for air.
I've lost weight thinking that was the main reason I had such terrible asthma issues etc.. and my asthma is still the same.
I am not able to afford my asthma medications and I'm like the other person on this blog who says "they are tired of putting all of the toxins" in their body. Just wondering what my body will be like in years to come from so many inhalers, prenidnisone, allergy shots etc..
I could fill up a page of all of the asthma medication I take. The sad thing is I HAVE INSURANCE but I can't afford to pay for my Rx's because of my high deductibale. My symbicort is $225.00 Flo vent is $201.00 and the list goes on.
If I could get a could deep breath I would be sighing now but I don't have enough air to take a deep breath.
Just trying to find some humor in this.
Thanks for listening.
I've had severe asthma my entire life (I am 56). It has seriously affected my quality of life. I wish I'd had such a procedure when I was two years old. The potential side effects would have to have been awful not to be an improvement.
I AM SICK OF HEARING OF OPTIONS THAT DON'T WORK. Treatment for Metabolic Syndrome? I was a scrawny 2-year-old when I was diagnosed. My grandson was a (correct-weight) 2-month-old consuming nothing but breast milk when he was diagnosed. This disease is not always about diet.
Drugs? I've tried all of them, and they all have serious side effects. Singulair has no side effects?! The box it comes in lists suicide as a possible side effect! Worst drug I ever took: if I thought I had to feel that awful to keep breathing I'd kill myself.
Breathing exercises? Useful, but, honestly, no match for an all-out asthma attack. Get a clue: if there's no air getting past your bronchi, it really doesn't matter whether your mouth is open or not.
Exercise? A surprisingly small amount of exercise sets off asthma attacks in some of us, and it's really difficult to finish your exercise program without breathing.
I want to see a major research effort into this treatment. I'd like to see it become common if it's safe enough. I won't hold my breath though: the FDA works for Big Pharma, who will never allow such a thing.
Bronchial Thermoplasty is currently sitting in some gov't workers in box at the FDA waiting approval. It was approved by the FDA's advisory committee and by the EU. So call the FDA, your congressman and senators and ask them why is it taking so long to approve this great procedure which has already helped 300 people.