KUALA LUMPUR - Chronic obstructive pulmonary disease (COPD), a significant yet often overlooked health issue in Malaysia due to low awareness and understanding, affects a considerable portion of the population, as well as being the third leading cause of death worldwide, with 3.23 million deaths in 2019.
Sunway Medical Centre, Sunway City consultant physician, respiratory medicine and interventional pulmonologist Dr Syed Ajmal Syed Ali said that low awareness is one of Malaysia's biggest challenges in combatting COPD as the disease, which includes conditions such as chronic bronchitis and emphysema, develop gradually over many years.
He noted that in Malaysia, the high prevalence of smoking is a primary driver of the disease, with approximately 19 per cent of adults over 15 years old being smokers.
"Smoking is the main risk factor for COPD and it is directly related to how much and how long you have smoked. Symptoms wise, COPD includes a persistent cough, often initially mistaken for a 'normal' smoker's cough or asthma. As a result, many are only diagnosed when their symptoms worsen, usually when they are older and over 60," he said in a statement today.
Quoting a finding from the Malaysia Adolescent Health Survey 2022, he mentioned a concerning trend, in which the use of electronic cigarettes (e-cigarettes) and vapes among Malaysian teenagers aged 13 to 17 increased from 9.8 per cent in 2017 to 14.9 per cent in 2022, while the cigarette smoking rate in the same group dropped from 13.8 to 6.2 per cent.
Dr Syed Ajmal said that there is a misconception that COPD is just a disease of old age, but it could affect younger people as well, especially those who smoke, with former smokers also at risk.
He said many patients are not familiar with COPD, often confusing it with asthma or simply attributing their symptoms to ageing due to lack of awareness, in which when coupled with the disease's slow progression, often leads to late diagnosis when treatment options are more limited.
As such, Dr Syed stressed the importance of public education on COPD, as well as efforts to raise awareness through media campaigns and support groups are crucial in encouraging early diagnosis and better disease management.
He noted, however, while smoking is the most well-known cause of COPD, environmental exposures, such as indoor air pollution from biomass fuels and occupational hazards like inhaling fine dust in certain industries, could also contribute to the disease, as well as a genetic component known as alpha-1 antitrypsin deficiency, which could lead to early-onset COPD even in non-smokers.
"This is because the genetic component protects the lung tissue from proteolytic damage. It affects approximately one in 2,000 to 6,000 individuals worldwide," he said.
Dr Syed Ajmal said, although COPD remains a serious health issue in Malaysia, increased awareness and access to treatment can lead patients to live better lives, and urged both current and former smokers to get screened for the disease, as early intervention makes a significant difference.
"Effective management of COPD focuses on slowing disease progression and improving the patient's quality of life. The most critical step in managing COPD is smoking cessation. To quit smoking is the single best thing a patient can do, as it prevents further lung damage, although the damage already done cannot be entirely reversed.
"In addition, pulmonary rehabilitation is an evidence-based programme designed to increase physical fitness, reduce symptoms and improve the overall quality of life for COPD patients, which typically runs for six to 12 weeks and includes exercise training, education, and support to help patients manage their symptoms," he elaborated.
He also highlighted the availability of pharmacological treatments such as inhalers, which help open the airways and reduce lung inflammation, besides newer treatments being introduced for advanced cases, including bronchoscopic lung volume reduction with endobronchial valves (EBV).
"This minimally invasive procedure involves placing one-way valves in the diseased parts of the lung, allowing trapped air to escape and healthy lung tissue to function better, which significantly improves breathing and quality of life for the right candidates," he added. - BERNAMA