Smokers who have been consuming a pack of cigarettes a day for the last 10 to 20 years have a high chance of developing the deadly Chronic Obstructive Pulmonary Disease or COPD.
As a chronic respiratory disorder, COPD - which is also called chronic airflow limitation disease - is characterized by a reduction of airflow from the lungs and an increase in air trapped inside the lungs. As more air is trapped in the lungs, air exchange or breathing progressively becomes more limited. Patients often complain of shortness of breath on vigorous physical exertion in mild COPD and on minimal exertion as it progresses to severe COPD.
According to Dr. Teresita de Guia, Head of the Department of Pulmonary and Critical Care Medicine of the Philippine Heart Center, “Smoking is number one cause of COPD”.
Based on clinical research, cigarette smoking accounts for 80% to 90% of the risk for developing COPD. About 15% of all heavy long-time smokers develop the disease. Even those constantly exposed to second-hand smoke over a 20-year period are also prone to develop the disease.
"We've had couples, where it is the husband who smokes but the wife is the one who gets COPD," Dr. de Guia added. Even long-time smokers who have already quit are still susceptible to developing COPD at a later age. People constantly exposed to air-borne dusts, irritating inhalants and even housewives who regularly use wood and coal-burning stoves and heaters are also prone to COPD.
To the average person, COPD may sound new but along with asthma, it is actually the number seven killer disease among Filipinos.
Often mistaken for asthma, a person suffering from COPD usually experiences shortness of breath, frequent morning cough and increased sputum production. In more advanced stages, the disease could make one dependent on an oxygen tank to breathe thus hampering a person's ability to perform normal daily activities.
"It is debilitating," Dr. De Guia said noting that COPD patients could not even climb a few flights of stairs much more ride an airplane at high altitudes.
Frequent morning coughing, often called smoker's cough, plus an increased mucus secretion are also symptoms of COPD, which covers both chronic bronchitis and emphysema.
Dr. de Guia also said most COPD patients often just dismiss the difficulty in breathing and other symptoms of the disease to old age, since COPD generally strikes after the age of 40. So they don't see a doctor until symptoms are already severe.
“But the moment the symptom starts, there is no abatement," Dr. de Guia said. "Sometimes it takes years before you feel the symptoms, but once you have the symptoms that means it is already severe."
She said COPD is also often misdiagnosed as asthma since its initial symptoms include difficulty in breathing. But Dr. de Guia noted that unlike asthma, which usually afflicts a person at a younger age, COPD develops typically in persons over 40. Shortness of breath or dyspnea upon exertion is also more common in COPD patients than in asthma.
COPD symptoms also tend to worsen with age while asthma symptoms are typically more episodic and stable over time. COPD could also lead to cardiac complications, while asthma does not. There is also a more direct link between smoking and COPD rather than smoking and asthma.
A misdiagnosis, she warned, could also worsen the disease since the medication is not the same.
A primary goal in treating COPD patients is to increase airflow, and consequently, improve their ability to participate in daily activities.
"The drugs are meant to relax the air passage. But you have to live with the disease," Dr. de Guia added. Some new medications may also have the potential to slow the progress of the disease.
But Dr. de Guia admitted there is still much to be done to educate the public about the dangers of COPD. "Here in the Philippines , we do not even have an equivalent of it in the local parlance unlike asthma which is called hika. And even in other countries, there is a lack of awareness about COPD," she added.
To remedy this, the COPD Council of the Philippine College of Chest Physicians is spearheading activities to create more awareness about the disease, including coming up with guidelines for doctors on how to diagnose COPD.
A World COPD day has also been declared every third Wednesday of November, where the Philippines is part of the celebration. "This shows that now, the world has realized the disability of people suffering from the disease," Dr. de Guia said.
With the help of research by pharmaceutical companies, doctors and patients have become more aware of the disease.
"Before we thought COPD was incurable," Dr. de Guia said. But with the introduction of new medicines coupled with pulmonary rehabilitation, there is hope for COPD patients.
One such medicine is tiotropium introduced by Boehringer Ingelheim (Phil.), Inc and Pfizer Inc. Clinical trials have demonstrated that tiotropium provides significant improvement in breathlessness or dyspnea, the most frequent and disabling symptom of COPD.
Dr. de Guia said Boehringer and Pfizer are helping a lot in COPD treatment through continuous research. The first inhaled COPD therapy was introduced by Boehringer 20 years ago. This, however, had a shorter effect of around six hours.
Boehringer and Pfizer have now introduced a bronchodilator that lasts for 24 hours improving a patient's mobility.
"This means a lot for COPD patients as it increases their mobility. Now they have more comfort as they do not have to use a bronchodilator every six hours," Dr. De Guia added.
Boehringer and Pfizer have committed to work together to help improve the quality of life of COPD patients the world over. A co-marketing agreement was put in place in order that more patients may receive this breakthrough treatment.
Pfizer Inc., the largest research-based healthcare company in the world is celebrating its 50th anniversary in the Philippines this year. "On our 50th anniversary, Pfizer is reaffirming its commitment to help improve the health and quality of life of the Filipino people, " said Pfizer president and country manager Gerry Bacarro.
"In the Philippines , Pfizer has worked tirelessly over the past five decades in making available various innovative and effective products, which helped in the treatment of serious, life-threatening diseases as well as common, everyday ailments. We are determined to continue to do so in the decades ahead, " Mr. Bacarro added.
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