- By Rita Rubin
Leonard Nimoy, best-known for his portrayal of Mr. Spock in Star Trek, recently announced that he'd been diagnosed with the serious lung disorder chronic obstructive pulmonary disease, or COPD, even though the 82-year-old actor says he quit smoking 30 years ago.
That's one of the frustrating things about COPD, which encompasses emphysema and chronic bronchitis, says Dr. Norman Edelman, a senior medical consultant for the American Lung Association.
“It progresses even after people stop smoking,” says Edelman, a professor of preventive medicine and of internal medicine at the State University of New York at Stony Brook. “We don’t exactly know why.”
But quitting smoking slows COPD’s destructive path, he says. The damage to Nimoy’s lungs would have progressed more quickly if he had continued to smoke.
“It’s never too late,” Edelman says. “Even if you’re 75 and you stop smoking, you will add breathing ability and even lengthen your life.”
A Leading Killer
COPD ranks behind only heart disease and cancer as the leading killer in the U.S. Smoking is the main risk factor, but air pollution and other lung irritants also play a role.
Most people with COPD have emphysema and chronic bronchitis. Emphysema damages the air sacs in the lungs; in chronic bronchitis, constant irritation and inflammation causes the lining of the airways to thicken, leading to the formation of thick mucus that can hinder breathing.
COPD sneaks up gradually — so gradually that half of the 24 million Americans thought to have the disease don’t know it, according to the American Lung Association. Symptoms include coughing up large amounts of mucus, shortness of breath, chest tightness and wheezing.
Up to 3 percent of people diagnosed with COPD are thought to have an undetected genetic disorder called alpha-1 antitrypsin deficiency, which can affect the liver as well as the lungs.
No Longer an ‘Old Man’s Disease’
Once considered an "old man’s disease," COPD now affects 1.5 times as many women as men. While it does tend to affect older adults more than younger ones, about 70 percent of people diagnosed with COPD are under 65.
“It starts after your first cigarette,” Edelman says. “Now that we have finer and finer ways of looking at the lungs … you can see emphysema in 20-year-old smokers if you look close.”
But, Edelman says, “People don’t realize they have a lung problem until they're well into the disease. We have a huge amount of excess lung capacity that only endurance runners use.”
By the time people most people are diagnosed, they’ve lost half of their lung function, according to the COPD Foundation, a nonprofit research, education and advocacy organization. Yet, Edelman says, when he asks patients when they first started noticing they were short of breath, “they’ll say three months ago.”
Often, that’s because they’ve been in denial, Edelman says.
“People, especially men, are great deniers of symptoms. All of a sudden, when you’re playing golf with your buddies, and you’re the last guy to come up to the last hole, well, you make up excuses,” he notes.
How to Test for COPD
If you’ve ever smoked, ask your primary care doctor for a simple breathing test, called spirometry, which can help diagnose COPD, Edelman says. And you can take the COPD Foundation’s five-question online screening tool to see if you’re at an increased risk for the disease.
“It’s not reversible, but it is treatable,” says Craig Kephart, the foundation’s executive director. “Unfortunately, all we can really do is sort of treat the symptoms right now.” Still, he says, “If you can catch this early, you can lead a pretty normal life.”
Treatments include bronchodilators to ease the muscles around your airways; inhaled steroids to help reduce inflammation; oxygen therapy and, as a last resort, surgery to remove damaged lung tissue. Pulmonary rehabilitation, which involves exercise training and nutritional and psychological counseling, can also help COPD patients breathe easier.
Nimoy’s Tweets Urged Fans to Quit
The COPD Foundation has contacted Nimoy’s agent with the hope of having him serve as a spokesman for the condition, Kephart says. “I want to commend him for coming out. It’s a highly stigmatized disease” because of its connection to smoking.
Nimoy disclosed he has COPD after he was photographed at an airport in a wheelchair and wearing an oxygen mask, according to E! News. Although he hasn't commented on the severity of his COPD, Nimoy urged fans to quit smoking via Twitter, according to The Los Angeles Times.
The actor is only the latest celebrity to be diagnosed with COPD.
Phil Everly, half of the singing Everly Brothers, died last month at age 74 after a long battle with COPD. His family has set up a memorial fund with the COPD Foundation. Johnny Carson, who smoked most of his life, including on camera during the early Tonight Show years, died of emphysema at age 79 in 2005.
For more information about COPD, call the American Lung Association’s toll-free help line at 1-800LUNGUSA (1-800-586-4872) or the COPD Foundation’s toll-free information line at 1-866-316-COPD (1-866-316-2673).
Rita Rubin is a former USA Today medical writer who now writes about health and science for media outlets including Next Avenue, U.S. News, WebMD and NBCNews.com.