Another Reason to Stop Smoking

While Chronic Obstructive Pulmonary Disease is not fully reversible, patients and physicians can take action to minimize the disease's progression, a pulmonary expert said last week.

COPD, which causes difficulty breathing, is the No. 4 cause of death in the United States, with 12 million people diagnosed each year. Additionally, 24 million people are suspected to be undiagnosed. Thirty-five percent of smokers develop COPD, said Joshua Rubenfeld, M.D., a member of the Sinai Hospital Division of Pulmonary and Critical Care Medicine.

Dr. Rubenfeld presented a COPD update at Sinai Hospital Grand Rounds last Thursday. Other risk factors for developing the disease include drug use, an HIV diagnosis, a family history, or those with an occupation that exposes them to gas or fumes.

To make a diagnosis, a physician must do a spirometry test, which involves blowing out as hard as one can into a small machine that tests lung capacity, and use a bronchodilator at least one to evaluate the effect. Diseases that can mimic the symptoms of COPD include asthma, pulmonary edema, tuberculosis, or broncostaxis, which is why it's important to nail down a COPD diagnosis.

COPD is a 'global disease', says Rubenfeld, as it can cause skeletal muscle wasting, osteoporosis,
kidney disease and other tobacco-associated diseases like coronary or cerebrovascular problems.

If it sounds like a grim prognosis, there is a way for a patient to take control: stop smoking. This will allow lung function to improve the first year and then allow the lungs to decrease at a normal rate. Additionally, those with COPD benefit the most from oxygen therapy, and physicians will also often prescribe corticosteroids, bronchodilators, or antibiotics. Still, “everything is palliative except for the oxygen,” Rubenfeld said.

The bottom line is that quitting smoking before a COPD diagnosis offers the best chance to breathe easy, and those who are diagnosed should stick with the recommended medications. As Rubenfeld explained, “hospital admissions for COPD exacerbations portend a poor overall prognosis, surgical therapy is risky, bronchoscopic therapy is unproven, and medical therapy is the cornerstone for helping the disease.”

To learn more about Dr. Rubenfeld or Sinai Hospital, call 410-601-WELL (9355).
-Elizabeth Leis-Newman