There are diseases that make the news and those we never hear about. But ignorance is certainly not bliss.
Chronic obstructive pulmonary disease, or COPD, is a progressive illness characterized by lung damage that makes it increasingly difficult to breathe. It is the fourth leading cause of death in Canada, and by 2030 the World Health Organization predicts it will be the third leading cause of death worldwide.
But unless they or someone they know has been affected by it, few Canadians – including many family physicians – are aware of how devastating this disease is.
And that means many at-risk patients don’t get the screening, preventive therapy or medical treatment they need until it’s too late.
The apathy could have something to do with the fact COPD is primarily a disease of smokers. There’s been a long-standing reluctance to rally around any ailment with even a perceived link to cigarettes.
Lung cancer, for instance, is deadlier than any other type and will represent more than one-quarter of all cancer deaths in Canada this year, according to the Canadian Cancer Society. But when was the last time you saw groups of men grow mustaches or companies sell specially coloured blenders for “lung-cancer awareness” month?
At least people are aware lung cancer exists. COPD lives mainly in the shadows, with many cases going undiagnosed and treatment not being effectively delivered. The disease sets in “almost imperceptibly, gradually depriving individuals of their health and vitality,” says a 2010 report from the Canadian Thoracic Society.
Often, individuals are diagnosed with chronic bronchitis, a persistent cough or a respiratory-tract infection when, in fact, they have COPD. The years go by and the disease progressively worsens, to the point of increasing disability, lung attacks that land them in the hospital and, eventually, death.
By the time many sufferers or their loved ones realize something is seriously wrong, the disease is already in its advanced stages.
This is a travesty. While there is no cure for COPD, the disease can be managed with medication and further damage can be prevented with early intervention, giving sufferers a greater quality of life and reducing the burden on the health-care system.
The best prevention is to get people to stop smoking, and when people realize they are at the early stages of COPD, while there is still time to intervene, many of them do quit, says Dr. Meyer Balter, director of the Asthma and COPD Education Clinic at Toronto’s Mount Sinai Hospital and a spokesman for the Canadian Lung Association.
Statistics Canada says that in 2013, more than 832,000 Canadians had COPD, a significant jump from 779,355 in 2011. The true scope of the disease is much higher.
Statistics Canada conducted a survey and found that 4 per cent of Canadians aged 35 to 79 had been diagnosed as having COPD from 2009 to 2011. Then, Statistics Canada conducted lung-function tests and found that, in reality, 13 per cent of Canadians in that age group likely had COPD – bringing the total number of cases into the millions.
If you’re in the camp that believes COPD is life’s penance for smoking and that as long as you don’t smoke, you won’t be affected, consider this: COPD is the No. 1 cause of hospitalizations in the country, excluding maternal and newborn care, according to the Canadian Institute for Health Information.
The disease is also linked to a high readmission rate, and those types of hospital stays are costly. The Canadian Thoracic Society notes that the total cost of in-hospital care for COPD patients is somewhere in the neighbourhood of $1.5-billion a year.
But also consider how callous it is to look away from smoking-related diseases. To do so is “nihilistic” and that pervasive attitude needs to change now, says Balter. It’s akin to accusing type-2 diabetics of eating themselves into a disease and using that as a justification for not treating the condition.
Family doctors are a big part of this problem – they simply don’t realize how seriously they should be taking this disease. Many don’t mention the condition to their patients and then fail to screen at-risk patients for COPD. Thousands of individuals with the disease are left undiagnosed and they themselves, unaware of the disease and its symptoms, don’t know to ask.
Physicians fret over patients with high blood pressure or bad cholesterol scores, yet they “don’t take COPD seriously,” Balter says. Where’s the sense in that?
Figuring out who is at risk is easy: The most vulnerable include smokers who regularly have bronchitis, or those who wheeze, have trouble maintaining their pace of daily activities or those who frequently cough and spit up phlegm. And diagnosing COPD is relatively cheap and quick.
Often, all it requires is a simple spirometry test, which measures a person’s lung capacity when they blow into a tube. While it’s not a cure, early intervention can give the gift of years.
Diseases shouldn’t be ranked in order of moral superiority. We’re all human beings. Let’s start treating each other accordingly.Report Typo/Error