Chronic Obstructive Pulmonary Disease (COPD) Frequently Asked Questions
COPD symptoms can vary widely from patient to patient. The most common symptoms are chronic cough, saliva/mucus production, shortness of breath (especially with exertion) and fatigue. Symptoms often progress slowly over time, or may come and go in people with milder stages of COPD. Symptoms can also suddenly worsen (called acute exacerbation).
There is currently no cure for COPD, since the damage it causes to the lungs is not reversible. There are things a person can do to prevent COPD from becoming worse, and there are an increasing number of therapies that can help ease the symptoms of the disease.
COPD is a chronic lung disease that is strongly linked to tobacco smoking. Other risk factors for COPD include exposure to air pollutants that come from burning wood or other biomass fuels, air pollution, genetic abnormalities, abnormal lung development and advancing age.
COPD is a preventable disease in most patients. The best way to prevent COPD is to never smoke tobacco and to avoid biomass fuels.
There are two goals when treating COPD: improve the symptoms of the disease and prevent a sudden worsening of the disease (called acute exacerbation). Quitting smoking is the best way to prevent COPD from getting worse. Other treatments may include:
- Bronchodilator inhalers in both short- and long-acting forms.
- Inhaled corticosteroids, which may be given in combination with a long-acting bronchodilator inhaler for people with persistent symptoms.
- Oxygen therapy for select patients with low levels of oxygen in the blood (severe hypoxemia).
- Oral medications (azithromycin, roflumilast) for people with sudden worsening of symptoms despite conventional therapy.
The four stages of COPD are mild, moderate, severe and very severe. Doctors determine which stage a patient is in by using a breathing test called spirometry. This test measures how hard it is for a patient to breathe out (called airflow obstruction).
Patients with COPD are also divided into four groups—A, B, C or D. Which group a patient is in depends on his or her symptoms and how often the disease worsens (exacerbates). The four groups progress from mild to severe, with Group A patients having mild COPD symptoms and lowest risk of exacerbation and Group D patients having severe symptoms and frequent exacerbation.
The life expectancy of COPD patients can vary greatly and depends on factors such as the severity of airflow obstruction, a patient’s smoking history and overall health. To determine a patient’s four-year survival rate, doctors use the BODE index to measure four different factors—body mass index, airway obstruction, dyspnea (a patient’s degree of breathlessness) and exercise tolerance.
Lung volume reduction surgery is a surgical procedure that removes diseased lung tissue from patients with advanced COPD. This surgery may improve symptoms and survival in carefully selected patients who have low exercise capacity and emphysema that is predominantly in the upper lobe of the lung. A minimally invasive, non-surgical approach called bronchoscopic lung volume reduction is currently being tested in clinical trials, but is not yet approved for routine use.