Chronic Obstructive Pulmonary Disease is a deadly killer, but most people
are unaware of what it is. Thats why the University of Nebraska Medical
Center and other research institutions around the world are trying to raise
awareness for COPD, the fourth leading cause of death in the United States
behind heart disease, cancer and stroke.
Stephen Rennard, M.D., Larson Professor of Medicine, pulmonary and critical
care medicine section of the internal medicine department at UNMC, has
been involved in the fight against COPD for more than two decades. He recently
served on the Global Initiative for Obstructive Lung Disease (GOLD) Committee,
a 15-member advisory committee made up of leading pulmonologists from around
the world.
The GOLD committee developed guidelines for treating COPD, which includes
emphysema and chronic bronchitis, two conditions that decrease airflow
in and out of the lungs.
Typically, it takes 30 to 40 years for COPD to develop fully enough
to cause symptoms. Before that, it is present, but silent, Dr. Rennard
said.
It is estimated that more than 16 million Americans suffer from COPD.Approximately
112,000 Americans die from COPD each year and 16 million more are undiagnosed.
COPD costs the U.S. economy more than $25 billion a year.
New government data based on a 1998 prevalence survey suggest that three
million Americans have been diagnosed with emphysema and nine million are
affected by chronic bronchitis.
Dr. Rennard is receiving approximately $1.5 million annually from a
total of $4 million in grants for COPD research projects at UNMC.
The UNMC COPD research studies include smoking cessation trials involving
the nicotine patch, nicotine gum and nicotine inhaler; investigations on
how to block cellular changes that occur with COPD;harm reduction studies,
which try to determine if smokers will be better off smoking fewer cigarettes;
as well as evaluations of new medications to improve the treatment of patients
with COPD.
Although it affects millions of Americans, the majority of medical
students, the public, and the health community in general remain uninformed
about COPD, Dr. Rennard said. Much needs to be done.
Dr. Rennard said 80 percent of COPD patients are cigarette smokers.
COPD is the only major cause of death that is increasing at the present
time. By the year 2020, it is anticipated that COPD will become the third
leading cause of death, Dr. Rennard said. This is a huge problem that
needs to be addressed not only in America but in other countries as well,
especially Asian countries. COPD is actually the number one cause of death
in China.
A report developed by a pharmaceutical company (GSK) found that although
patients and physicians are generally optimistic about advances in COPD
treatment, there is still a strong need for more education about how to
better manage the condition.
A COPD survey illustrates the tremendous impact the disease can have
on people. Describing their worst three months in the previous year, 58
percent said they had shortness of breath every day and 23 percent of patients
said symptoms woke them up every night.
In general, 51 percent of COPD patients say the condition limits their
ability to work. In addition, COPD limits normal physical exertion, 70
percent; household chores, 56 percent; social activities, 53 percent; sleeping,
50 percent; and family activities, 46 percent.
COPD symptoms also are shown to be a cause of great distress for patients.
· 58 percent say they panic when they cant get their
breath; 52 percent feel they are not in control of their breathing; and
52 percent admit that their coughing is embarrassing in public.
· 47 percent say they have a hard time making plans because
of their condition, and 39 percent worry about having serious breathing
problems when away from home.
· 66 percent say they expect their condition to get worse.
Although COPD is a progressive disease, statistics reveal younger patients
of ages 45 to 54 report more severe and frequent symptoms and a greater
psychosocial impact compared to older patients. This is a counterintuitive
finding, as older patients, not younger patients, should report the greater
impact. One explanation is that younger patients are more sharply aware
of their symptoms, while older patients have either grown more accustomed
to symptoms or restrict their activities to avoid breathing problems.
For more information on COPD studies being conducted at UNMC, call (402)
559-7396 or (402) 559-6335