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Cancer doesn't cure smoking, new study reports

Robin Wulffson MD's picture
lung cancer, colorectal cancer, smoking, smoking cessation program

BOSTON, MA - According to a new study by researchers at the Massachusetts General Hospital/Harvard Medical School in Boston, a “substantial minority” of lung cancer and colorectal cancer patients continue smoking after being diagnosed. Furthermore, colorectal cancer patients were even less likely to quit than lung cancer patients. It has been well established that continued smoking after a cancer diagnosis is likely to impact treatment effectiveness, subsequent cancer risk, and survival. The study was published online on January 23 in the peer-reviewed journal Cancer.

Once a patient receives the dreaded diagnosis of cancer, their treatment focuses on fighting the disease; however, according to lead author, Elyse Park, PhD, MPH, her team’s findings underscore the need for more than just a pharmacological (medication) approach. She explained that any cancer patient who is a smoker should be assessed and receive both behavioral and pharmacological treatment; however, “very few cancer patients actually receive that.” She noted that such treatment is necessary because a number of studies in the medical literature report that continuing to smoke has negative effects on cancer treatment outcomes.

The researchers evaluated 5,338 lung and colorectal cancer patients; they compared their smoking rates at the time of diagnosis and five months after diagnosis. Initially, 39% of lung cancer patients and 14% of colorectal cancer patients were smokers. Five months later, 14% of the lung cancer patients and 9% of colorectal cancer patients were still smoking. Dr. Park noted, “The message that we receive from this is that oncology clinicians should screen for smoking, and consider treating it as a part of comprehensive cancer care.”

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A number of factors and traits were involved in whether a patient continued to smoke. For lung cancer patients, those that continued to smoke tended to have pre-existing factors such as having public health insurance, a lower body mass index, and low emotional support. Colorectal cancer patients who kept smoking tended to have completely different characteristics such as being uninsured, having a lower education level, and being of male gender.

Dr. Park noted that continuing to smoke was a “multifaceted issue.” She noted that a common perception is held is that cancer patients are stressed; thus, they continue to smoke. In addition, both healthcare professionals and family members are often skeptical that the patient possesses the will power to quit after a cancer diagnosis because they were unable to quit after past attempts. Thus, healthcare professionals were reluctant to add a new treatment, which thy felt would be unsuccessful.

Dr. Park noted that it was extremely important to treat the patient on both a physical and mental level. She explained, “Almost all smokers want to quit smoking, but they don’t have the tools they need to quit and stay quit.” She noted that most anti-smoking programs are focused on cancer prevention; thus, a cancer patient could feel isolated from joining such programs. She added that there was a hesitancy to join a smoking cessation group when one has been already diagnosed with cancer. Dr. Park and her team are planning further studies to investigate this topic.

Reference: Cancer