Lung disease is a leading cause of death in the United States every year.

And chronic obstructive pulmonary disease (COPD) is considered the third leading cause of death behind heart disease and cancer.

COPD shows itself as emphysema or chronic bronchitis and is most common in smokers.

Kelli Thompson and Jody Nogan run the Lung and Wellness Centers of Western Pennsylvania in Butler, which offers therapy to people battling the illness.

“There are 12 million people in the U.S. diagnosed with the COPD,” Thompson said. “And there’s another 12 million more that have not been diagnosed.”

Dr. Amanda Adams, a primary care physician with Butler Medical Associates, said missed diagnosis of lung diseases is far too common.

“It’s massively under-diagnosed,” Adams said. “I actually diagnose it all the time because I go looking for it because of how much it goes untreated.”

Adams said common symptoms of COPD include coughing every day with mucus and difficulty breathing. She added that early morning “smoker’s cough” is perhaps one of the most common signs of COPD.

If a person thinks he might be at risk for COPD or any lung disease, it is important to see a doctor to get the illness diagnosed early, Adams said.

There are four stages of COPD, and early detection is key to saving the most lung function possible.

“There are treatments that can help manage the symptoms and preserve lung functionality,” Adams said. “But diagnosing it early will put people on the road to really preserve lung function.

“Everyone already only gets a certain amount of lung function in life. We need to preserve it.”

Thompson and Nogan treat people with any kind of lung disease at their clinic, including asthma, but COPD is one of the most common diseases.

One of the key aspects of the clinic is to keep patients from having to make numerous trips to the hospital, which face financial penalties if patients return within 30 days with the same illness.

This is a major problem with COPD patients because the illness doesn’t lend itself to an overnight recovery.

“Around 27 percent of COPD patients return to the hospital within 30 days,” Nogan said. “Therapy can take that percentage and decrease it by 50 percent. It does work.”

Exercise and education on the disease are the main objectives in treatment.

“The clinic offers endurance and strength training to help better the quality of life and manage the disease process,” Nogan said.

“We’ve had people that haven’t showered in a year because they are so short of breath and can’t make it up the stairs,” Nogan said.

“We get people that can only exercise for a minute when they start the program, and we build them up to 20 minutes.”

“It’s life changing for people that aren’t able to take care of themselves,” she said.

Nogan and Thompson, who both have been respiratory therapists for more than 30 years, said one of the biggest elements of the program is the sense of camaraderie.

“People with COPD can feel isolated sometimes,” Nogan said. “When they come here, they can connect with others and learn from each other.”

The main program lasts six to 10 weeks while patients can enter a maintenance program after that.

Louise Lunn, 80, of Prospect has been in therapy for eight years.

“It’s very nice here,” Lunn said. “I feel a lot stronger when I come here. It’s very helpful.”

While exercise therapy can improve a person’s ability to deal with COPD, the most crucial step in the recovery process is to quit smoking. But that is not an easy task.

“Quitting smoking can be one of the most difficult things a person can do,” Adams said. “Most want to quit because it’s been proven over and over that it’s bad for you, but it’s addicting. It’s very difficult to do.”

Adams said being confronted by a doctor is one of the biggest steps in finally being able to quit, but it is still up to the patient.

“Studies have shown that being told by a physician helps people stop smoking,” Adams said. “But I don’t have a magic bullet for it.”

While quitting smoking reduces the risk for COPD, it doesn’t eliminate it.

“I find it in people who did smoke for a number of years but quit 15 years ago,” Adams said. “People need to know there are consequences.”