Chronic obstructive pulmonary disease (COPD) It affects approximately 12% of the Spanish population And this is happening more and more often. In fact, the disease is expected to rise from the fifth leading cause of death to the fourth leading cause of death. According to data from the National Health System Annual Report 2020-21, the crude mortality rate from chronic obstructive pulmonary disease in Spain in 2019 was 29.3 per 100,000 inhabitants, which is much higher than the number of deaths from traffic accidents.
In this context, it should be noted that although today There is no treatment that can reverse the damage to the lungs. In the context of this disease, Yes, there are treatments that can improve symptoms and thus slow or even prevent their progression, however, the main problem with the approach and management of this pathology is underdiagnosis.. The evidence is that although it is the most common chronic respiratory disease, Eight out of 10 patients are not even diagnosedthis is largely due to a lack of awareness of the impact COPD has on patients’ lives and its severity.
In this regard, Dr. Salud Santos, director of the Department of Pulmonology at Bellvitge Hospital and a specialist in COPD, recalled: “The disease develops gradually. The first symptoms usually appear around the age of 40. They present with difficulty breathing when walking or running quickly, like a feeling that the lungs are not filling properly, coughing, feelings of fatigue, more severe symptoms with respiratory infections…and are associated with higher cardiovascular risk and other comorbidities like diabetes . Smoking is the most important risk factor About 30% of smokers develop this disease. “therefore, When young people begin to notice “these symptoms,” they often attribute them to tobacco and often rule out going to counseling because they feel guilty about smoking and know that the first thing professionals will tell them is to quit smoking. .”
no early diagnosis
In this context, Most often, the diagnosis is not made until the disease is already very severe. By that time, the symptoms are severe and obvious, and the impact of COPD on a patient’s quality of life is real and very significant. “Five per cent of patients arrive at hospital very seriously ill and usually end up admitted””, Dr. Santos emphasizes that he remembers in this regard “Advanced stages of the disease require frequent hospitalizations, patients require oxygen and ventilation, patients are unable to leave their homes, and may even result in the need for a lung transplant and established mortality.”.
As the head of the pulmonary department at Bellevue Hospital emphasizes, it is obvious that “If a patient already needs hospitalization when they first come to the clinic, we’re doing something wrong,” because that means the disease has progressed to an advanced stage. “Lung damage is irreversible. The lungs are damaged and cannot regenerate, but if the disease is detected early and treatment is initiated, people with COPD can live a good quality of life well into old age”. Improve symptoms and exercise tolerance.
“Through medication and preventive treatment, including rehabilitation and/or physical therapy, “It is possible to slow or even stop the progression of the disease, but not to restore lung function.”Dr. Santos assured, noting in this regard “So it’s critical to understand the importance of screening, which includes spirometry to measure an individual’s lung capacity and how well their organs are functioning so that diagnosis is very simple.”
The key is to raise awareness
Therefore, patients must see a doctor as soon as symptoms appear, rather than waiting until the symptoms become more obvious, seriously affecting life and health, causing greater damage to the lungs, and never being able to regenerate.However, the reality is “If the first symptoms of COPD usually appear around age 40, the average age at diagnosis is 60, so by the time diagnosis is made, 20 years have passed since the disease began, and during that time, it has been progressively progressing “
Therefore, for Dr. Santos, It is important to raise awareness about respiratory health among people, especially smokers. “When a smoker begins to notice the first symptoms at age 40, on the one hand, he attributes these symptoms to smoking, which masks them; on the other hand, he does not realize that over time, the condition These symptoms can get progressively worse as they continue to develop, so they don’t see a doctor until the COPD has already progressed and caused more lung damage,” whereas patients should see a doctor as soon as they notice respiratory problems. A simple spirometry can diagnose the disease and start treatment early, reducing its impact on an individual’s health and quality of life.
Diego, real case
And that’s something Diego will always regret, because he didn’t have the knowledge and information about the disease that would have made it possible to be diagnosed earlier. “I am 54 years old and was diagnosed with COPD seven years ago. I am now on treatment and using an inhaler twice a day but still My abilities are very limited: I can barely walk 400 meters, getting dressed and making my bed are very difficult for me…” “I know this will be the end of me,” Diego admitted that he was knocked unconscious by a cough and was taken to hospital only to learn he had COPD.
“I’ve had a lot of coughs in my life, but no matter how many times I went to the doctor, they couldn’t find the right answer. They told me I had asthma, chronic bronchitis, but no one told me COPD. 18 At age 10, “When I started smoking, I started to smoke and at the same time I started coughing, which made me collapse and pass out.I thought it was a typical smoker’s cough until one of those coughs and I ended up in the hospital and they diagnosed me,” recalls Diego, who recognized this “Before that, I hadn’t even heard of the disease.”
“There was a lot of ignorance about it, at least at the time,” he said, before adding categorically, “If I had known I had this disease, I wouldn’t have smoked because I would be so much better now… Because of the ignorance, My health deteriorated.” The patient commented, fully aware that if he had more information, he would have been diagnosed earlier. “Starting treatment 7 years ago is not the same as 15 or 20 years ago.” .