Chronic obstructive pulmonary disease, or COPD, is a deadly condition that claims more than 120,000 lives in the United States every year, but it can be prevented and treated if it is detected early and its underlying causes, primarily cigarette smoking, are eliminated.
COPD Is Deadly But Treatable -- And Preventable
By Dennis Connaughton
10/4/2007
"Early Diagnosis of COPD" was the subject of a 60-minute seminar on Oct. 3 led by Barbara Yawn, M.D., M.Sc., adjunct professor of family and community health at the University of Minnesota, Rochester, and Dennis Doherty, M.D., professor of pulmonary medicine at the University of Kentucky Academic Medical Center, Lexington.
"People say COPD is a death sentence," Yawn said. "About half of all COPD patients die within a decade of diagnosis. We can't prevent people from dying and we can't cure COPD, but we can treat it, and we can prevent it in younger people."
COPD encompasses emphysema and chronic bronchitis. "It is characterized by airflow limitation with very minimal reversibility. It is almost always progressive, and it is associated with an inflammatory response of the lungs to noxious particles or gases," she said.
As an increasing number of women have taken up smoking, the number of women who have developed COPD also has climbed. In fact, since 2000, more women than men have died of the disease, and misdiagnosis is common in women, Yawn said.
"People say COPD is a death sentence," Yawn said. "About half of all COPD patients die within a decade of diagnosis. We can't prevent people from dying and we can't cure COPD, but we can treat it, and we can prevent it in younger people."
COPD encompasses emphysema and chronic bronchitis. "It is characterized by airflow limitation with very minimal reversibility. It is almost always progressive, and it is associated with an inflammatory response of the lungs to noxious particles or gases," she said.
As an increasing number of women have taken up smoking, the number of women who have developed COPD also has climbed. In fact, since 2000, more women than men have died of the disease, and misdiagnosis is common in women, Yawn said.
People at Risk
Current and former cigarette smokers are at risk for COPD, as are people exposed to dust and toxic chemicals at work and those exposed to indoor and outdoor air pollution. Aging smokers who have smoked a long time are especially vulnerable.
COPD causes airflow obstruction that traps air in the lungs, resulting in hyperinflation of the lungs, dyspnea, limited activity and a poor health-related quality of life, Doherty explained.
Symptoms include progressive dyspnea, a cough that produces sputum, and a decline in physical activity, exercise tolerance and ability to perform activities of daily living.
Spirometry is recommended to confirm the diagnosis of COPD in symptomatic patients, but not as a screening test for current or former smokers, Yawn said. The lower a patient’s forced expiratory volume, or FEV1, the less likely the patient will survive three years or more.
According to Doherty, "COPD is not only a disease of the elderly. Family physicians should begin evaluating patients in their 30s for COPD, especially those with exposure to toxins."
COPD causes airflow obstruction that traps air in the lungs, resulting in hyperinflation of the lungs, dyspnea, limited activity and a poor health-related quality of life, Doherty explained.
Symptoms include progressive dyspnea, a cough that produces sputum, and a decline in physical activity, exercise tolerance and ability to perform activities of daily living.
Spirometry is recommended to confirm the diagnosis of COPD in symptomatic patients, but not as a screening test for current or former smokers, Yawn said. The lower a patient’s forced expiratory volume, or FEV1, the less likely the patient will survive three years or more.
According to Doherty, "COPD is not only a disease of the elderly. Family physicians should begin evaluating patients in their 30s for COPD, especially those with exposure to toxins."
Therapy for COPD
Primary therapy for COPD is to help patients stop smoking and support those who have quit. Bronchodilators, including beta-agonists, anticholinergics and methylxanthines, can be given to reduce hyperinflation. Supplemental oxygen also is a therapeutic option for hyperinflation. For patients with an FEV1 of less than 50 percent, inhaled corticosteroids with or without long-acting beta-agonists are beneficial, Doherty said.
A pulmonary rehabilitation program consisting of exercise reconditioning and breathing retraining can help patients improve their symptoms, he added, and can be tailored as a home exercise program. Lung-volume reduction surgery and bronchoscopic lung-volume reduction procedures are available but are not considered cost-effective.
The symptoms of COPD occur late in the disease process, Doherty said. "Early recognition of reduced lung function can lead to specific action plans that may potentially slow the progression of the disease," he concluded.
A pulmonary rehabilitation program consisting of exercise reconditioning and breathing retraining can help patients improve their symptoms, he added, and can be tailored as a home exercise program. Lung-volume reduction surgery and bronchoscopic lung-volume reduction procedures are available but are not considered cost-effective.
The symptoms of COPD occur late in the disease process, Doherty said. "Early recognition of reduced lung function can lead to specific action plans that may potentially slow the progression of the disease," he concluded.
News From 2007 Annual Assembly