Approaches to COPD

When I say I work on Chronic Obstructive Pulmonary Disease (COPD), I usually get one out of two responses: sage nodding or confused smiles. Invariably, the nodders are those who know someone with COPD or work within the field. If you have ever seen anyone suffer from the disease, you’ll remember it. But if you have never encountered COPD directly, you’d be forgiven for not knowing too much about it. It has a low profile compared to diseases of similar impact. Unfairly so.

By way of background, chronic respiratory disease kills almost as many people as lung cancer in England and Wales each year, with the total annual toll being approximately 29,000. COPD makes up a large part of these numbers. The WHO estimates that COPD will be the third leading cause of death worldwide in 2030. Those numbers alone should warrant attention.

copd_deaths

In the UK, COPD is predominantly caused by smoking. The British Lung Foundation states that 80% of all cases are caused by long-term cigarette smoking, and that about 25% of all long-term smokers will develop the disease. Therein lies perhaps part of the problem with the public profile of COPD. There’s a disproportionate amount of blame to go around in ‘self-inflicted’ lung diseases, COPD included. This stigma is a barrier both to resource allocation (treatment availability, research funding) and to patients (treatment seeking behaviour), and contributes to making COPD a greater problem than it needs to be. Smoking cessation is important, but if we truly want to improve outcomes in COPD, we must let go of the moralising and focus on the medicine.

copd_cause

Furthermore, COPD is typically diagnosed late, its primary symptoms often confused for signs of aging or smoker’s cough. The treatment that many patients receive is too little too late. While it is not curable, it can be treated, and the effectiveness of treatment depends on early diagnosis. Increasing the profile of COPD, both with the public and healthcare professionals, is a way to remedy this.

I’ll let Mr Spock have the last word, as is appropriate:

nimoy(Leonard Nimoy, 1931-2015)

Advertisements

2 thoughts on “Approaches to COPD

  1. Very well said. I agree with you completely in all respects. My dad was diagnosed with Chronic Obstructive Pulmonary Disease. What followed when we went to the doctor was exactly as you said it. The first question the doctor asked my dad was whether he was a smoker. When my dad admitted he was, the doctor’s attitude changed almost immediately. It was as if he felt he had inflicted the symptoms onto himself and so there was no point trying to treat it. It does seem rather harsh to damn smokers who have COPD just because well, ‘they smoked and so they deserve it. Causes and Diagnostic Techniques of COPD

    Like

    • Thanks for commenting, and I’m sorry to hear about your dad’s experience. I don’t believe it is acceptable to suggest (through words or actions) that anyone deserves to suffer from COPD, and I’d expect better from a doctor. Nobody deserves any disease. The stigma of COPD makes life harder for all patients (including never-smokers) and shame and guilt keep people from seeking treatment. Everybody loses. It should be possible to advocate for smoking cessation (indeed, many people with lung disease heeded health warnings and stopped years ago) AND treat patients to the best of our ability, and with empathy and respect. I firmly believe we can and should do both.

      Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s