Sanjay Gupta, MD, Everyday Health: If you have a newly diagnosed patient with COPD and you are talking to that patient, what do you tell them? How optimistic are you? How pessimistic are you?
Ronald Crystal, MD, Pulmonary Disease Specialist at Weill Cornell Medical College: Well, the biggest thing is smoking. You have to really convince them as much as you can to stop smoking.
Dr. Gupta: We know there are a lot of smokers who don't get it, and a lot of people who get it who aren't smokers. What else is going on there?
Dr. Crystal: Well, one of the fascinating things is we know that cigarette smoking causes probably 85, 90 percent of the cases. But the fact is probably 80 percent of smokers don't get the disease. So this is a sort of classic example of genetics and the environment. If your parents had it, then clearly you are at more risk from a genetic point of view, and I would be very strong with that patient to stop smoking if they could. It's hard because nicotine is a real addiction.
Dr. Gupta: If they stop, if they had COPD, but now they stopped smoking, what can you tell them? What sort of benefit does it offer with regard to COPD?
Dr. Crystal: Well your risk for the progression of COPD and also risk for development of lung cancer goes down if you stop. Never goes away. So you never go back to normal, but certainly the risk significantly decreases.