The silent killer
Although little known by the general public, COPD is one of the biggest killers in the western world
In 90 per cent of cases Chronic Obstructive Pulmonary Disease (COPD) is related to smoking. Photograph: Daniel Acker/Bloomberg News
Along with heart disease and cancer, Chronic Obstructive Pulmonary Disease (COPD) is one of the biggest killers in the western world. Yet, unlike, heart disease or cancer, it is barely known among the general public except by those who suffer from it.
The Irish Heart Foundation and the Irish Cancer Society have done stellar work over decades in raising both funds and awareness of their illness. By contrast, the first support group for the hundreds of thousands of Irish people with COPD was only set up last month.
COPD consists of two conditions. The first is chronic bronchitis where the breathing tubes produce excessive amounts of mucus. This is often known as a smoker’s cough. Emphysema is where the interstitial part of the lung (the tissue and space around the air sacs of the lungs) is destroyed over years, usually by smoking. There is less surface area for oxygen to get across into the bloodstream leading to shortness of breath which can go on for years. In many cases COPD patients have both conditions and they are not separated out from a clinical point of view.
There are 12,000 confirmed admissions to hospital with COPD in Ireland every year and approximately 100,000 diagnosed with the condition, but the number of those undiagnosed is estimated to be twice that of those who are undiagnosed meaning there are at least 300,000 people living with COPD in Ireland at present, making it a huge public health issue.
Yet, for many sufferers, it is an illness that dare not speak its name. “It is an illness with a certain stigma. Patients themselves are embarrassed by it,” said Professor Tim Mc Donnell, the head of the HSE’s COPD programme.
The embarrassment stems from the fact that 90 per cent of COPD is caused by smoking. Most of the rest of those with the condition have an underlying lung disease such as asthma.
The illness does not have the profile of other conditions because it predominantly affects people in the lower socioeconomic groups.
Prof McDonnell is frank about the consequences of the disease’s profile in Ireland: “This is a problem for the illness. It is socially acceptable to get a coronary despite not looking after yourself, but there is a degree of stigma about COPD that is reinforced by people who are in the lower socio-economic classes. These are a disenfranchised group of patients.”
COPD Support Ireland is running a free screening programme throughout the country this week.
It will be targeted at people over the age of 40 who have got symptoms of shortness of breath and have a history of smoking.
COPD is not a curable disease but it is treatable and treatments have improved over recent years. However, many patients still die.
Not all people with COPD are currently smokers. Finola Cadenhead (68) was off cigarettes for 12 years by the time she was diagnosed with COPD in 1998.
Her sister too was diagnosed with COPD.
When diagnosed, she came home crying as she had an aunt who had died from COPD at age 60 and all she could picture was her aunt hooked up to an oxygen tank for the remaining years of her life.
Prior to giving up cigarettes, she was smoking 20 a day. “If I had never smoked, I was always going to have chest problems such as chest colds, but because of my aunt, I was determined to stop smoking,” she said.
“Smokers are cutting their lives short. When I see youngsters smoking, I cringe. If you give me smoking and take up exercise you can lead a normal life with COPD but you have to be careful.”
A dedicated COPD screening bus is travelling to a number of cities nationwide this week. It is in Mayo today (which is World COPD Day), Thursday in Waterford and Friday in Cork.
Specialist nurses will be available to screen patients for COPD and COPD Support Ireland will have local members on hand to provide practical advice and support for those looking for information on the disease.