Emphysema and COPD

Did you know that Cigarette Smoking causes more cases of emphysema than all other causes combined? In the early stages of emphysema, stopping smoking completely arrests the disease and returns lung function to normal. In advanced disease, kicking the habit still improves lung function and decreases cough and shortness of breath.

Doctors and nurses at C.A.R.E. Clinical Research use the latest techniques to help you stop smoking. These include drugs to suppress the smoking urge, nicotine replacement, and behavioral therapy.

Contact us about ways to stop smoking

In advanced emphysema, patients lose weight despite their best efforts to maintain body weight.

Contact us about participation in studies of new treatments for emphysema and COPD..

Primer On Emphysema

Pulmonary emphysema, sometimes called chronic obstructive pulmonary disease (COPD), affects some ten million people in the USA today. Most people develop emphysema from cigarette smoking, but a few can inherit the disease or develop it from industrial exposure.

Since cigarette smoking causes most cases of emphysema, great emphasis is placed on stopping smoking (smoking cessation). Stopping smoking is not easy but many people have been able to stop smoking. Most people accomplish this by going "cold turkey." For those who cannot stop this way, various aids to smoking cessation are available:

• Nicotine replacement products and drugs such as Zyban: Nicotine-containing chewing gum, skin patches, nasal spray and inhalers. A new nicotine-containing lozenge is now available. The gum, patch and lozenge can be purchased without a prescription. The nasal spray and inhaler require a prescription. Follow the instructions for the product carefully. Buproprion (Zyban or Wellbutrin SR) and Chantix have shown promise in helping people stop smoking. The drugs seem to decrease the craving for cigarettes that many people feel.

• Smoking cessation programs are conducted by many hospitals and private groups. These programs basically employ the principles of group therapy to help small groups of smokers reinforce each other and stop together.

• Research has shown that nicotine replacement with or without buproprion (Zyban) or Chantix work best when combined with a smoking cessation program. No matter how a person stops, the important thing is to stop.

If you can't stop the first time you try, DON'T GET DISCOURAGED. Try again. If you fail again, DON'T GET DISCOURAGED. Try again. The most effective treatment for emphysema is complete and permanent smoking cessation. It literally stops the progression of emphysema and puts the disease into remission.

Many patients with emphysema respond to bronchodilators. These drugs are usually given by inhalers. The most widely used are ipratropium bromide (Atrovent) and drugs related to adrenaline (albuterol, Proventil, Ventolin, Serevent) or combinations (Combivent). Inhaled cortisone-like medications (steroids) are increasingly being used, and one combination drug (Advair) has been approved for treatment of COPD. Inhaled steroids seem to offer only a small beneficial effect.

When emphysema flares up with increased cough and sputum (acute bronchitis or AECB), antibiotics and steroid medications are given by mouth or intravenously.

Special Circumstances

Immunizations: Emphysema increases your likelihood of catching bacterial pneumonia and viral influenza. Remember to get your flu vaccination every year and get the pneumonia vaccine (Pneumovax) very five years.

Exercise: People who are short of breath tend to stop exercising. They then become weaker and exercise even less. This vicious circle can lead to a patient getting little or no exercise and becoming house-bound. Get your exercise, even if it's only a brisk walk every day.

Nutrition: When you become short of breath, you tend to eat less. This can lead to significant weight loss. Remember to eat three full meals every day. If you can't eat three large meals, try eating five or six small meals daily. Dietary supplements such as Ensure or Sustecal may be helpful. Recently, a new drug called oxandralone (Oxandrin) has shown promise in helping people with severe emphysema to regain lost weight.

Oxygen: Oxygen benefits people with emphysema whose blood oxygen is too low. See your doctor to determine if you are a candidate for oxygen therapy.

Lung volume reduction surgery: This surgery can help some people with severe emphysema to breathe better. Recently a large government-sponsored study identified emphysema patients who benefit from this surgery. At this time, Medicare coverage for this surgery is not available. See you doctor about the benefits and risks of this surgery.

Lung transplantation: Single lung transplants have helped people with severe emphysema. Many large university medical centers perform this surgery.

Unproven Therapies

Emphysema causes great suffering and is difficult to treat. A number of unproven therapies are constantly being offered by mail and over the Internet. These therapies may involve combinations of herbs and vitamins. Occasionally, a drug that has shown promise in animal research (vitamin A derivatives or retinoids) will be advertised.

Please be cautious about these offers. Many times the sellers mean well, but there is usually very little scientific basis for what they are offering. Sometimes these ventures are driven only by greed. No drug or other therapy is absolutely safe, and the potential for harm always exists, especially with an unproven therapy.

The medical profession and the various research agencies are not keeping secrets from you. Research is going on constantly to improve the treatment of emphysema, but we do not want to advocate a treatment that lacks proven benefit or, even worse, might be harmful.

New Drug Studies

We are now testing new medications for COPD and emphysema. If you live in the St. Louis area and are interested in learning more about clinical research and how it might benefit you or a loved one, please contact our offices and we will be glad to assist you. If you live out of the St. Louis area, check with our medical links page for information on clinical trials in your area.

Other Sites To Get Help

American Cancer Society: www.cancer.org/tobacco

Nicotine Anonymous: www.nicotine-anonymous.org

SmokEnders, Inc: www.smokenders.com

American Lung Association: www.lungusa.com