Chronic Obstructive Pulmonary Disease (COPD)

Diagnosing Chronic Obstructive Pulmonary Disease (COPD)

The same doctors attempting to research the different types of chronic obstructive pulmonary disease (COPD), provide care for peop le with COPD at the UPMC Comprehensive Lung Center. They recognize that not all treatments help every patient with COPD.

A comprehensive clinical assessment focuses on correct disease classification and the selection of treatment options unique to each patient’s disease characteristics.

To determine the best route for treatment, UPMC specialists will:

• Ask about your symptoms
• Evaluate your medical history
• Perform a physical exam

Symptoms of COPD

The most common symptoms of COPD include:

• Coughing
• Coughing up clear sputum or mucus from deep in the lungs
• Wheezing
• Shortness of breath with activity

COPD is most commonly a disease of smokers, although not all smokers develop COPD.

Testing for COPD

COPD can be recognized in the very early stages by asking your doctor to perform a test called spirometry. A spirometry test measures the maximum speed, or flow, of air coming from your lungs when you are asked to blow out as fast as possible.

This is a very important test, especially for smokers, to identify the disease in the earliest stages. Early recognition of COPD can lead to interventions, which successfully slow the decline in lung function.

COPD clinicians in the center have a complete set of treatment options to offer, several of which were actually first investigated at UPMC.

In addition to all current treatment options, people with COPD who visit the center can participate in the newest clinical treatments for COPD through a disease research registry.

Chronic Obstructive Pulmonary Disease (COPD) Treatments

The Emphysema/COPD Research Center has participated in national clinical research trials that have confirmed new important treatment options for chronic obstructive pulmonary disease (COPD), including:

• The critical role of smoking cessation in stopping disease progression.
• The appropriate use of oxygen therapy for patients that meet appropriate criteria.
• The careful selection of drug therapy to maximize effectiveness, while minimizing the cost to the patient.
• The important role of exercise therapy, or pulmonary rehabilitation, in limiting shortness of breat h and improving a person’s quality of life.
• The need for attention to nutritional status and bone health in managing people with COPD.
• The role of surgical intervention, or lung volume reduction surgery, for a highly select population of individuals with COPD.
• The option of lung transplantation for people with very advanced disease and disabling symptoms.

For some patients with COPD, medical therapy will not be enough and they may be evaluated for other types of treatment, including lung transplantation. The UPMC Lung Transplantation Program is nationally renowned. Our experts have performed more than 1,400 lung transplants since the program’s inception.

Our doctors work closely with members of the Lung Transplant Program to refer patients for evaluation, when the time is right.

Exploring new options for treating COPD

As long as COPD remains a disease without a specific cure, our researchers will continue to explore new options for treatment of the disease.

While the list of research investigations is constantly updated, a sample of current studies includes:

• Using peripheral blood chemical tests in people with COPD to study gene expression, biomarker presence, and bacterial colonization. The goal is to classify patients correctly with the premise that this will lead to the right individualized treatment.
• Using advanced x-ray techniques, called high resolution CT scans, to study the type and distribution of COPD changes in the lungs to reclassify COPD into distinct subcategories, or “phenotypes.” Knowing the specific COPD phenotype of patients may, one day, help doctors develop individualized treatment plans to fight the disease.
• Placing small valves into the lung to replace the prior use of surgery for people with specific types of emphysema. Our researchers were recognized in the New England Journal of Medicine for their early work confirming the safety and potential use f or this “less invasive” method of treating emphysema.
• Testing novel forms of immune suppression — including oral cyclosporine and statin medication — in the COPD patient population, based on prior studies that strongly suggest an autoimmune process may contribute to progression of the disease process.
• Re-evaluating the role of oxygen therapy to select all patients with COPD who might benefit from this form of therapy.