COPD: Listen to Your Lungs
Chronic obstructive pulmonary disease kills 29,000 people every year in Spain. This, coupled with the fact that it is under-diagnosed and under-treated, makes doctors consider it a public health problem.
Symptoms such as difficulty breathing while exercising, chronic coughing, wheezing, or chest pressure may indicate that whoever is affected by them suffers from chronic obstructive pulmonary disease (COPD).
The main cause contributing to its development is smoking, although there are other factors that influence it, such as, pollution and certain specific personal characteristics, such as an abnormal lung development.
In Spain, 29,000 people die each year from this disease, making it the fourth biggest cause of death. However, one of the major problems is undeniably the lack of diagnosis, since it is estimated that three out of four patients do not even know that they are suffering from this condition, resulting in under-treatment. All this makes medical professionals consider COPD as a public health problem. "It is a preventable and treatable disease," says Julio Ancochea, head of the Pneumology Service at La Princesa Hospital in Madrid, who believes it is essential to emphasize its prevention.
“The binomial COPD-tobacco is virtually indissoluble, since in Spain approximately 80% of those affected by chronic obstructive pulmonary disease are or have been smokers,” says the pulmonologist, who also indicates that they usually develop “In the fifth or sixth decade of life this is the case.”
Doctor Ancochea is blunt: “a bronchodilator spirometry should be performed in the event of symptoms such as difficulty breathing when physical exertion, accompanied by coughing, occurs in people over 35 who smoke more than one pack a day, which is the test that allows the diagnosis of COPD to be established.” This way, if the condition is detected at an earlier stage, it will be easier for the specialist to find a treatment that will help to attack it and mitigate the symptoms. As Ancochea indicates, “74% of the population is under-diagnosed. For this reason, the pulmonologist indicates that one of the challenges in dealing with this disease is to make spirometry more accessible in the field of primary care.” If the disease is diagnosed early, it is relatively easy to slow its progress.
The problem can arise when evil advances untreated. It is a disease with frequent extrapulmonary manifestations and risk of developing other conditions associated with the same COPD or related to aging and smoking, according to the specialist. Some of these side-effects, Dr Ancochea says, could be “cardiovascular disease, lung cancer, and the development of other types of tumors”. In addition, with the passage of time, the symptoms may increase, so he urges early intervention “to prevent the patient from being affected by the degree of disability that prevents him from working.''
As for the itinerary a patient must follow to carry out the treatment, Ancochea clearly stipulates the first rule: quit smoking. “It is what has been shown to truly modify the natural history of illness and improve quality of life,” he says. From there, living a healthy life, exercising and getting vaccinated every year against the flu and pneumonia.
In addition, the pulmonologist stresses the need for patients to follow the treatment correctly. In fact, according to data from the Observatory of Adherence to Treatment, half of the patients with COPD do not meet the guidelines set by the doctor. According to Dr Ancochea, in COPD treatment is increasingly personalized. To decide the most suitable for each patient, variables such as the level of risk and the phenotype, which are the characteristics of each organism, are analyzed.
