About Gary Expertise Will attempt to answer any question on respiratory disease, but please don`t ask me to make a diagnosis. Although I`ve worked as a respiratory specialist nurse in the UK for 6 years, I know nothing about the health systems of other countries. I have a particular interest in asthma, COPD, spirometry, and tuberculosis.
Do you know what advances there have been in the treatment of COPD? And, what new and/or alternative treatments are there for COPD?
Thank you,
John McKinzie
Answer Hi John
I prefer to refer to them as "therapies" because using the word "treatment" suggests there is a cure and, of course, there is no known cure for COPD.
However, there a number of therapies. The most important, and the one proven to make a difference is "smoking cessation". People with COPD should be encouraged and helped to stop smoking at every opportunity.
There are various "inhaled therapies". I guess the newest is a long-acting bronchodilator (an anti-cholinergic bronchodilator) called "Spiriva" although it may have a different trade name in other countries. It doesn't so much open the airways but it stops them from closing. It lasts about 24 hours in the lungs so it only needs to be used once a day. It has worked well in lots patients that I know. it comes in an inhaler.
There are many other "inhaled bronchodilators" on the market as well as inhaled steroids too, but none of them are particularly new so you will probably know about them already.
"Oxygen therapy" in carefully selected patients can help. If given to the right people (and accurate assessment is the key) it can increase survival as well as improve quality of life. However, if it is given to the wrong people, it can have a negative effect on quality of life because people get attached (physically rather than psychologically) to a therapy that is no use to them.
There is also "Pulmonary Rehabilitation". It isn't very new but is slowly becoming popular in the UK. It is proven to make a difference in (carefully selected) patients.
"Nutritional assessment and support" is also helpful, as is "psychological assessment and support". The former because we know many COPD patients are under nourished, therefore they have low energy, therefore they can't exercise, therefore they get muscle wastage, therefore they have little stamina, therefore they get fatigued easily, therefore their muscles demand more oxygen that their lungs can't deliver (basically, it's a vicious circle). The latter because many patients with COPD are depressed and this affects their ability to exercise and cope with their altered lifestyle. By addressing this, these problems can be sorted out.
There is "lung volume reduction surgery" that can help a small minority of patients too but this is a very specialist thing.
Some people will benefit from "non-invasive ventilation". This is a type of mask that fits over the nose and blows air into the lungs keeping them supplied with oxygen.
Finally, it's a good idea for people with COPD to get a "flu jab" and a "pneumococcal jab" every autumn/winter. They are at increased risk from these infections so the added protection of vaccination is a good thing.
It would be advisable to discuss various options with your doctor/nurse.
