„If everyone would stop smoking tomorrow, we would still have a high number of patients with COPD in the next 30 years“, says Prof. Dr. Taube. He must know, because he is the head of the West German Lung Center at the University Hospital Essen. It is one of Germany’s largest specialist clinics for patients with COPD.
Prof. Dr. Taube was already concerned with Chronic Obstructive Pulmonary Disease (COPD) in his doctorate. After working at the National Jewish Centre in Denver/USA and at Leiden University Medical Centre/Netherlands, today he works as Director of the Clinic for Pneumology of the Ruhrlandklinik which is part of the University Medicine in Essen. According to the hospitals’ quality report, 1,381 patients with COPD were treated there in 2018, more than in most hospitals in Germany. This is why Prof. Dr. Taube is amongst the most experienced doctors in Germany when it comes to COPD.
Clinic Compass: Worldwide, several million people die of COPD every year. What would have to happen in order for the number of patients to decrease?
Prof. Taube: COPD represents an ever-growing socioeconomic problem worldwide. COPD is an illness which is caused by the inhalation of harmful substances. The most important factor for the disease is the inhalation of cigarette smoke. This means that for a decreasing number of patients, more people would have to stop smoking. However, to this day we know that if by tomorrow, everyone would stop smoking, we would still have a high number of COPD patients in the next 30 years, because the damage has already taken place after decades of smoking.
Clinic Compass: There is no cure for COPD, nevertheless the symptoms can be improved. In your doctorate, you found out that physical training can help. Which new therapeutic approaches give you hope?
Prof. Taube: The current COPD therapy consists of several pillars. On the one hand, inhalative medication is used in pharmacotherapy. Another important pillar is physical training and rehabilitation. These two interventions made especially clear that the symptoms can be improved. In the case of very severe disease, sometimes a long-term oxygen therapy or a non-invasive ventilation is the method of choice. It has become apparent that for patients with a severe emphysema, also volume-reducing measures such as surgery or interventional bronchoscopic procedures can help in order to alleviate the symptoms. For a few patients, a lung transplantation is also possible as a last option. However, all of these therapies only alleviate the symptoms, but COPD is not yet curable. That is why preventive work is extremely important.
Do you also treat patients from abroad?
Prof. Taube: We treat a lot of COPD patients with all degrees of severity. The patients come from the Ruhr area as well as from other federal states in Germany. Of course, we also treat patients from abroad, but the majority of our patients comes from North Rhine-Westphalia.
Clinic Compass: Let’s take a look into the future: In ten years, will patients with COPD be treated the same way as today?
Prof. Taube: There are few new pharmacological approaches that are being studied today. If you take into account how long the development of new medication including the necessary authorization of new substances can take, the probability is low that we will have new pharmacological possibilities in ten years. The interventional methods in the context of volume reduction or the bronchocopic procedures are being studied more intensively at the moment, which is why they could play a more important role in the treatment of severe COPD in the future.
Clinic Compass: You have worked in the USA, in the Netherlands and in different German cities. Are there special therapies for COPD that you got to know that were completely new to you?
Prof. Taube: No, from a medical point of view, Germany has one of the best health systems and research is up-to-date. Nevertheless, there are differences. In the Netherlands, there is a significantly higher regulation when it comes to the treatment of patients with rare or complex diseases. There, the formation of Centers for rare diseases is significantly more advanced than in Germany. In the Netherlands, there are clear rules on who can treat patients with pulmonary fibrosis, who is allowed to carry out transplantations and who can implement new procedures from oncology. Diseases and complex surgical interventions are concentrated in certain Centers, in order to improve the quality of treatment.
Prof. Taube, thank you for the interview!
Picture: ©Ruhrlandklinik/University Medicine Essen