MORGANTOWN, W.Va. – Tobacco’s link to cancer is well known, and smoking can interfere with some cancer treatments. But do patients quit tobacco after a cancer diagnosis? Do their doctors urge them quit? Not often enough, a West Virginia University team of researchers says in a study published this month in the Journal of Oncology Practice, a peer-reviewed publication of the American Society of Clinical Oncology.
Less than half of the smokers surveyed, 44 percent, quit during treatment for cancer. Less than two-thirds, 62 percent, said they had received advice during treatment from their healthcare providers on the dangers of smoking – despite a strong continuing risk to their health.
“We were surprised to learn that doctors and nurses across the board were not counseling cancer patients about the advisability of quitting,” said Jame Abraham, M.D., section chief of hematology/oncology at WVU’s Mary Babb Randolph Cancer Center, the study’s lead author. “Clearly there is a need for intervention programs to help cancer patients quit the tobacco habit.”
“We found that even those patients who continue to smoke are interested in smoking-cessation programs,” said Lola Burke, a second-year medical student at WVU, who played a key role in the study.
In the patient population, some 20 percent of patients were smokers at the time of cancer diagnosis, split evenly between men and women. But of those who were not currently smoking, more men than women were likely to have smoked in the past (55 percent to 32 percent), the study found.
Smoking is a risk factor not just for lung cancer but also for cancers including bladder, kidney, esophagus, pancreas and head and neck. Smoking can complicate the common cancer treatments of surgery, chemotherapy and radiation therapy – interfering with wound healing and decreasing the effectiveness of anti-cancer drugs.
“Previous studies have shown smoking increases mortality rates. If cancer survivors continue to smoke, they are more likely to die of cancer,” Abraham said. “Our hope is to identify and create better ways for patients to quit smoking, taking advantage of the higher success rate that may be achieved right after a cancer diagnosis.”
To carry out the study, the researchers randomly selected a pool of 1,000 cancer patients who were diagnosed between 2003 and 2007. Of 1,000 questionnaires sent out, the study analyzed 166 responses. Most of the patients had attended high school, and more than a quarter had attended or graduated from college.
Those who had never smoked were more likely to be better educated than those who were current or former smokers.
The top three cancers represented in the study were breast, skin and prostate cancers, followed by head and neck cancers, lung cancers and lymphomas.
The authors suggest, based on the patients’ preferences expressed in the questionnaire, that intervention to help cancer patients quit smoking take one of two forms: individual counseling by a healthcare professional or lifestyle changes promoted through group therapy with other cancer patients. The patients surveyed expressed little desire to participate in programs that would involve friends or members of their families.