Experts have urged health professionals to discard "nihilistic" attitudes toward patients with chronic obstructive pulmonary disease (COPD) and "have hope."

Speaking at Clinical Consensus in COPD, held last week in London, UK, Conference Chairman Peter Calverley (University Hospital, Aintree, UK) acknowledged the negative school of thought that has lingered around COPD patients.

He said some clinicians have thought "You're all damned because you all smoke and there's nothing we can do." But added: "I don't believe that."

Bart Celli (Tufts University, Boston, Massachusetts, USA) agreed, saying that "the first big myth is that COPD does not respond to therapy."

In fact, the evidence indicates that there are many effective forms of therapy, Celli explained.

Smoking cessation programs have significantly lowered smoking rates in the USA, and similar efforts across the world should have the same impact, he predicts.

Long-term oxygen therapy has lengthened the survival of hypoxemic patients, and new drugs have improved levels of dyspnea and quality of life.

Recent studies show that pulmonary rehabilitation improves the BODE (Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index in COPD) index, and non-invasive ventilation offers new options for physicians treating patients with acute or chronic lung failure.

Also, physicians may soon have alternatives to lung transplantation in the most severe cases, with the revival of surgery for emphysema or the upcoming endobronchial lung volume reduction, he says.

"I still have the dream that if we decrease lung volume we can improve outcomes," he told the conference.

"We undersell ourselves about what we can do," he said. "Let us have hope."

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