HomePatientsLung Disease Week at the ATS2015COPD Week ▶ General Information
General Information

Emphysema / COPD Week

COPD is a disease of the airways and lung tissue that causes difficulty with the transfer of oxygen into the bloodstream and with moving air in and out of the lungs. It is an inflammatory process that breaks down the fragile air sacs in the lungs and obstructs the airways with mucus and constriction of the muscles surrounding the airways. The inflammatory process affects not only the lungs, but also the entire body and can result in unintentional weight loss and muscle wasting. COPD can be caused by a genetic enzyme deficiency (alpha one antitrypsin deficiency), and it can also be caused by exposure to inhaled toxins such as cigarette smoke; cooking with biofuels in enclosed spaces is a common cause of COPD in developing countries.

People living with COPD often experience significant breathlessness and cough that limit their ability to participate in daily activities. Without realizing it, people with COPD may decrease their activities to avoid breathlessness and then experience physical deconditioning which leads to more breathlessness, and a downward spiral of inactivity/breathlessness/deconditioning results. Paradoxically, the best intervention to minimize breathlessness in a person with COPD who has experienced this spiral of inactivity is to increase activity/exercise levels and push through the breathlessness, realizing that usual breathlessness in COPD is not dangerous and can be controlled. As the person becomes more conditioned, they will be able to tolerate more activity with less breathlessness.

COPD usually occurs after many years of exposure to inhaled toxins and is often diagnosed in the late 50s and early 60s, either due to gradually increasing breathlessness or following a hospitalization for exacerbation (lung infection or “flare-up”). It shares risk factors with cardiovascular disease and cancer, and the care of people with COPD is often complicated by managing multiple diagnoses with sometimes conflicting treatment requirements. Disease management can be complicated by the need to coordinate between primary and specialist care, inpatient and outpatient settings, and the burden of self-management requirements for optimal daily care. Palliative care with its focus on symptom management, quality of life, relief of distress related to illness, and providing health care consistent with the patient’s personal values is an important resource for people with COPD. The gold standard for treatment of moderate COPD is pulmonary rehabilitation which meets 2-3 times per week for 6-12 weeks of supervised exercise, education on a wide variety of topics related to COPD management, and social support for living with chronic lung disease. Support is also available for loved ones and caregivers affected by the illness.

Smoking cessation is a top priority for patients with COPD. Inhaled medications designed to open the airways and relieve inflammation are the cornerstones of treatment. Supplemental oxygen is available for patients who require it, and prompt treatment of exacerbations is a priority to prevent deterioration of lung function. Daily self-management activities such as symptom management, energy conservation, exercise training, medication adherence, and exacerbation treatment take a lot of time and training, but are important for successfully living with this chronic illness. Although not appropriate for all patients with COPD, surgical procedures including lung transplant for selected patients, can provide relief of breathlessness and reduce the need for supplemental oxygen. Many patients report benefits from integrative therapies such as yoga, mindfulness, and acupressure; although definitive research has not yet been done on these therapies, they may be a valuable addition to individual patients’ self-management programs. Research studies focused on additional genetic causes of COPD, stem cell therapy, and subtypes of COPD are currently underway.

COPD has transitioned from a terminal illness to a manageable chronic illness within the past decade. While the search for a cure continues, many resources are available to support people living with COPD in living productive and satisfying lives.

DorAnne M. Donesky, PhD, ANP-BC
University of California, San Francisco
Member, ATS Board of Directors

Four Facts About COPD

  1. COPD is the third leading cause of death in the U.S., twelve years earlier than predicted.

  2. Every four minutes an individual dies of COPD.

  3. COPD kills more women than men each year. In 2006, COPD killed more American women than breast cancer, Alzheimer’s and diabetes.

  4. The National Heart, Lung and Blood Institute estimates that 12 million adults have COPD and another 12 million are undiagnosed or developing COPD. COPD cost the U.S. government approximately $42.6 billion in both direct and indirect expenses in 2007. A majority of those expenses are due to hospitalizations, which can be prevented with better diagnosis and management practices.