Chronic obstructive pulmonary disease (COPD) is an umbrella term for long-term, progressive lung diseases that cause breathing difficulties. COPD shares some similarities with asthma.

Cigarette smoke is the leading cause of COPD. About 75% of individuals with the condition smoke or have smoked in the past. In nonsmokers with COPD, exposure to lung irritants such as air pollution, dust, and fumes may be responsible for the condition. Genetics may also play a role.

COPD is the third leading cause of death worldwide. However, although it is a severe disease, treatments and lifestyle changes can reduce a person’s symptoms and extend their life.

This article answers the question of whether COPD is fatal. It also looks at how COPD affects daily life, the treatment options, and the life expectancy for people with this condition.

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COPD can be fatal. In 2019, it contributed to about 3.23 million deaths worldwide, making it the third leading cause of death globally.

More than 80% of these deaths occurred in low- and middle-income countries. However, COPD is a significant cause of disability and the fourth leading cause of death in the United States.

Doctors typically diagnose COPD in middle-aged or older adults. About 16 million people in the U.S. currently live with a COPD diagnosis, and experts believe that many more people have the condition without realizing it.

Although COPD is a serious condition, lifestyle changes and treatment can prevent complications and slow the progression of the disease.

The life expectancy of a person with COPD depends on various factors, including the severity and stage of the disease.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) publishes guidelines for assessing COPD severity. It recommends using a measurement called the forced expiratory volume (FEV1) percentage.

The FEV1 test measures how much air someone can expel from their lungs in 1 second. This test is a strong predictor of life expectancy. The results are a percentage of the predicted airflow for an individual, according to their weight, height, and race.

GOLD has four grades that also consider a person’s breathing difficulties and number of symptom flare-ups:

  • 1: FEV1 more than or equal to 80% predicted.
  • 2: FEV1 50–80% predicted.
  • 3: FEV1 30–50% predicted.
  • 4: FEV1 less than 30% predicted.

As the GOLD stage increases, life expectancy decreases. For this reason, people should take steps to manage their symptoms and seek appropriate treatment to limit damage to their lungs.

However, the FEV1 only captures one component of COPD severity and life expectancy. Due to this, two individuals with the same FEV1 can have a substantially different exercise tolerance and outlook.

Therefore, other aspects of the disease, such as the severity of symptoms, the risk of COPD exacerbations, and the presence of comorbidities, are important to the person’s outlook. Newer staging systems, such as the revised GOLD classification, take these factors into account.

Another system that doctors may use to assess COPD severity and survival is the BODE index. This score is based on the person’s:

  • weight
  • FEV1
  • symptoms of shortness of breath
  • exercise capacity

This index provides better information relating to outlook than the FEV1 alone. Doctors can use it to assess how well a person is responding to medications, pulmonary rehabilitation therapy, and other interventions.

Currently, there is no cure for COPD.

However, it is a treatable chronic disease. With the help of a healthcare team, a person can manage the symptoms and ease their breathing difficulties.

The most crucial step in COPD management is stopping smoking and reducing exposure to lung irritants such as secondhand smoke, air pollution, fumes, and dust.

Doctors may also recommend various medical treatments or home remedies to address a person’s symptoms.

Bronchodilators

These inhaled medications relax the muscles surrounding the airways, which opens them and eases breathing.

There are two types of bronchodilators. A person with mild COPD may only require a short-acting bronchodilator that lasts 4–6 hours.

However, a person with moderate or severe COPD may also need long-acting bronchodilators appropriate for daily use. The effects of long-acting bronchodilators last about 12 hours or more.

Combination bronchodilators with inhaled glucocorticosteroids

If a person has severe COPD, a doctor may recommend these combined medications. Typically, doctors do not advise using an inhaled steroid alone, but it can help reduce airway inflammation.

A person may use inhaled steroids with the bronchodilator for an initial trial period of up to 3 months to see whether the additional steroid helps ease breathing problems.

Vaccines

Doctors may recommend that people receive the yearly influenza vaccine and stay up to date with current COVID-19 vaccination guidelines, since these respiratory diseases can cause severe issues for those living with COPD.

Likewise, doctors may recommend the pneumococcal vaccine to reduce the risk of pneumococcal pneumonia — another disease that can cause serious complications in people with COPD.

Pulmonary rehabilitation

Pulmonary rehabilitation is a therapy program that helps improve the lives of those with chronic breathing issues.

Rehabilitation may involve:

  • a physical activity program
  • disease management training
  • nutritional information
  • psychological counseling

The rehabilitation team may include doctors, nurses, physical and respiratory therapists, dietitians, and exercise specialists. Together, these experts tailor a program to help the person remain active and carry out necessary daily activities.

Oxygen therapy

People with severe COPD may benefit from oxygen therapy to help increase blood oxygen, facilitate breathing, improve alertness in the day, and promote better sleep at night.

A person uses an oxygen tank and a mask or nasal prongs to breathe. They may need oxygen for most of the day or only at certain times, such as during physical activity.

Surgery

A doctor may recommend surgery for individuals with severe COPD that does not improve with medications.

However, a pulmonologist may consider evaluating the person for one of the newest treatment options for severe emphysema. This is a minimally invasive, nonsurgical procedure called bronchoscopic lung volume reduction (BLVR).

BLVR is a procedure that the Food and Drug Administration (FDA) has approved for selected individuals with severe emphysema and hyperinflation. The procedure involves the insertion of one-way valves into the most affected lobe, thereby allowing air to exit but not re-enter.

Potential surgical options include:

  • Bullectomy: During this procedure, a surgeon removes large bullae from the lungs. These are large air spaces that form due to the destruction of the walls of the air sacs.
  • Lung volume reduction surgery (LVRS): Surgeons remove damaged lung tissue in this procedure, helping the lungs function better to improve breathing.
  • Lung transplant: This involves replacing damaged lungs with healthy lungs from a donor. However, although the surgery can improve a person’s quality of life, there are various risks, such as organ rejection and infections.

For most people, a COPD diagnosis is life-changing. Daily tasks may become more challenging, and there are also emotional factors to consider.

However, while this diagnosis may feel overwhelming, it is important to note that most people with COPD can maintain a good quality of life. Here are some tips to staying as healthy as possible while managing the disease:

  • Protect the lungs: COPD weakens the lungs, so it is essential to reduce exposure to any substances that could worsen the symptoms. These include cigarette smoke, workplace dust and fumes, and environmental pollution.
  • Adjust diet: Although it may seem unlikely, foods can affect breathing. For example, fat metabolism produces the least amount of carbon dioxide for the oxygen that the body uses, and carbohydrate produces the most. Therefore, the right combination of nutrients can help ease breathing difficulties.
  • Exercise: People living with COPD should aim to keep active, as exercise has many health benefits.
  • Take care of mental health: It is advisable to find emotional support through friends and family or support groups to help navigate any fear, anxiety, or depression that a person may experience.

People living with COPD and their caregivers can benefit from a support system that allows them to share experiences and tips.

The American Lung Association (ALA) provides a free lung helpline that provides information and support from lung health experts. A person can connect by calling 800-LUNGUSA (800-586-4872 and press 2), submitting a question through the form, or using live chat.

The ALA also has an online support community, where a person can reach out to other individuals having the same experience.

For people who prefer face-to-face meetings, the Better Breathers Club program offers national events.

Chronic obstructive pulmonary disease is a long-term lung condition that affects a person’s breathing ability.

COPD is the fourth leading cause of death in the U.S. and a significant cause of disability worldwide.

Although the condition is serious, it is essential to understand that with the correct medication and treatment, people living with COPD can minimize their symptoms and the impact of the disease.