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Guest column | Dr. Rao Musunuru

Lung disease can't be cured but can be slowed

Learn more and get the most out of each breath. Chronic obstructive pulmonary disease, or COPD, is the fourth-leading cause of death in the United States, after heart disease, cancer and stroke, in that order.

It affects one in four Americans over the age of 45; 12-million Americans are diagnosed with chronic obstructive pulmonary disease and an equal number are estimated to have it but not know it. They may have never even heard of it. Most of them do not know what it means.

November is designated COPD Awareness Month to spread the word about this disease. It causes one death every four minutes in the United States, in addition to causing serious long-term disability. Presence of chronic obstructive pulmonary disease increases the risk of development of lung cancer up to 4.5 times.

It is a serious lung disease that over time makes it hard to breathe. The airways — tubes that carry air in and out of the lungs — become less elastic and are partly blocked, which makes it hard to get air in and out. The walls between many of the air sacs are destroyed. Chronic obstructive pulmonary disease includes emphysema and chronic bronchitis.

It is characterized by constant coughing — for example, smoker's cough — and shortness of breath on exertion, excessive sputum production, wheezing and not being able to take a deep breath even at rest, as the condition worsens. Not everyone with chronic obstructive pulmonary disease has a cough and not everyone with a cough has the disease. It has to be distinguished from other conditions like asthma.

Smoking is the most common cause of chronic obstructive pulmonary disease. It can also develop as a result of long-term exposure to things that can irritate lungs like certain chemicals, dust, fumes, or secondhand smoke. An uncommon genetic condition known as AAT deficiency can cause chronic obstructive pulmonary disease even in nonsmokers because of increased destructive proteins damaging the lungs. If people with this condition smoke, the disease progresses more rapidly.

There is no cure for chronic obstructive pulmonary disease. The damage to airways and lungs cannot be reversed. Prevention is the key. Early diagnosis and prompt intervention are the most important elements to slow the lung damage.

Chronic obstructive pulmonary disease can be detected by your physician with a simple breathing test called spirometry, which measures the amount of air a person can blow out of the lungs. It helps your physician not only to make the diagnosis, but also to determine the best course of treatment.

If you smoke, the best thing you can do to prevent more damage to your lungs is to quit. Also, try to stay away from other irritants and pollutants, including passive smoking. Your doctor may prescribe medications like bronchodilators, which relax the muscles around your airways; and inhaled steroids, which reduce inflammation and swelling of air tubes. If your chronic obstructive pulmonary disease is severe, your doctor may suggest oxygen therapy. In a few patients with very severe chronic obstructive pulmonary disease, lung surgery involving lung volume reduction or a transplant may be an option. Avoiding crowds during flu season, receiving a flu shot every year and a pneumonia shot every five years will help. Support groups and pulmonary rehabilitation are usually available through local hospitals.

If symptoms get worse suddenly, because of lung infection or heart strain, your best option is to call the ambulance to be taken to the closest emergency room. Do not attempt to drive. Take your list of medications with you.

See your doctor regularly to help manage chronic obstructive pulmonary disease, to improve your quality of life. It is not curable but is treatable. You may breathe easier just knowing your treatment options.

Rao Musunuru is a Bayonet Point cardiologist and a current member of the Advisory Council for National Heart, Lung, and Blood Institute, or NHLBI, at the National Institutes of Health.

Lung disease can't be cured but can be slowed 11/23/08 [Last modified: Saturday, November 29, 2008 8:53pm]
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