Brief Answer: It may mean that your disease is advanced. Detailed Answer: Hello XXXX, Your doctor may mean that your disease is advanced and it may be becoming difficult to control the symptoms. But you have not mentioned any thing about your symptoms and their severity. Or may be doctor is exasperated and trying to stress the importance of quitting smoking because that remains the first and foremost part of treatment of emphysema/COPD. Before elaborating any further it is important to know about your general condition so you may post your symptoms in this forum and i`ll try and answer them.

---

Brief Answer: Your disease does seem to be advanced. Detailed Answer: From your symptoms and description of chest x ray/ct scan findings, your disease does seem to be advance and it may be difficult for your PCP to control the symptoms. Still you must make an all out attempt and quit smoking straightaway as this is the most important step in the management of your disease. You must continue with your inhalers and other treatment as presribed by your PCP. Preventing episodes of acute excerbation is equally important. Do some deep breathing exercises and some physical exercise like walking for gradually increasing distances. In very advanced stages there is option of domicilliary oxygen therapy or non invasive ventillation. For this you may have to consult a pulmonologist.

---