Chronic obstructive pulmonary disease, or COPD, takes decades to develop. Continued inflammatory attacks on the lungs and airways—such as from smoking—lead to damage in the air sacs or bronchial tubes that cannot be reversed.
“COPD cannot be cured. It is a chronic disease, so once you have it, you have it,” says Margarita Oks, pulmonologist at Lenox Hill Hospital, Northwell Health.
However, COPD is also a progressive disease. Symptoms of COPD, such as shortness of breath and coughing with mucus, may get worse over time if not effectively managed. For this reason, treatment is incredibly important to avoid more severe symptoms and other health complications.
“The goal of treatment is to keep the disease as stable as possible—to make sure that it does not progress, that your lung function does not deteriorate, and [that] we can maintain a person’s daytime functioning,” says Dr. Oks.
There are several treatment options available for COPD to meet these goals.
“The mainstay treatment options are bronchodilators,” says Dr. Oks. “These are medications that reduce the inflammation in the airways and make it easier for you to breathe.”
Bronchodilators are typically in the form of inhalers, and there are two types for COPD, according to the American Lung Association (ALA):
Beta-agonists mainly relax the muscles to ease breathing. They come in a short-acting form (for quick but short relief) and a long-acting form (for slow but long relief, such as overnight).
Anticholinergics help keep the muscles from tightening, as well as help keep mucus out of the lungs to make it easier to cough and clear out mucus. As with beta-agonists, anticholinergics are available in both short-acting and long-acting forms.
Steroids, or corticosteroids, are an anti-inflammatory medication that can be either inhaled or taken as a pill. In addition to reducing inflammation, they also decrease the amount of mucus production in the airways, since fluid production is a byproduct of inflammation.
While steroids for COPD are very strong and highly effective at relieving symptoms, they are typically only used temporarily and for extreme or special circumstances, as they come with more severe side effects. For example, they may be used if someone is sick and it’s exacerbating their COPD, according to Dr. Oks.
Steroids may also be used in combination with a bronchodilator, and they can be taken at once in the same inhaler.
Oxygen therapy uses an external device that supplies supplemental oxygen through a face mask or nasal prongs. While oxygen equipment is commonly associated with COPD, not everyone with COPD will need oxygen therapy. It’s typically only used for more severe cases of COPD, according to Dr. Oks.
Pulmonary rehabilitation is a formal program that includes education on the condition, exercise training, and nutrition advice, according to the ALA. This program is useful for anyone with a chronic lung disease, including COPD, and it’s recommended for people whose symptoms are seriously limiting their everyday life.
“This is absolutely a livable disease, so while it is a disease, and you have to take care of yourself when you have it, it’s definitely something that you can live with,” says Dr. Oks.