TOBACCO CESSATION AS AN IMPORTANT PART OF CANCER

TOBACCO CESSATION AS AN IMPORTANT PART OF CANCER MANAGEMENT Mini Lecture 5 Module: Tobacco Effects and Neoplasia

Objectives of the Mini Lecture Goals of Mini Lecture: Provide students with knowledge about the importance of smoking cessation in relation to cancer treatment. Learning Objectives: Students will be able to: • Understand how tobacco use affects cancer treatment and management. • Understand the barriers to tobacco cessation faced by cancer patients. • Know how cessation helps in preventing cancer.

Contents Core Slides 1. Smoking Affects Cancer Treatment 2. Impact of Smoking Cessation on Cancer Management 3. Barriers to Smoking Cessation in Cancer Patients 4. Cessation and Cancer Prevention 5. Cessation in Cancer Survivors 6. Screening—A Must Do!

CORE SLIDES Tobacco Cessation as an Important Part of Cancer Management Mini Lecture 5 Module: Tobacco Effects and Neoplasia

Smoking Affects Cancer Treatment • Tobacco smoke and its constituents have active biological effects that can interact with cancer treatments. • Smokers under cancer treatment have increased risk of experiencing postoperative complications like delayed wound healing and pulmonary and cardiovascular complications, as compared to nonsmokers or former smokers. • Smoking increases complications of radiation therapy and can adversely affect outcomes. 1 1. Cooley et al. 2008

Impact of Smoking Cessation on Cancer Management • Lung cancer patients who stopped smoking reported • decreased fatigue • decreased shortness of breath • increased activity level • improved appetite, sleep, and mood. 1 • Postsurgical pulmonary complications can be significantly reduced when patients stop smoking at least 4 weeks before surgery. 2 • The longer the interval between smoking cessation and initiation of cancer treatment, the better the prognosis. 2 1. Cooley et al. 2008; 2. Gritz et al. 2006

Barriers to Smoking Cessation in Cancer Patients • Heavy nicotine dependence • Urgency of cessation • Fatalistic attitudes about cessation benefits • Cancer-related psychological distress • Treatment factors • Presence of smokers in the social network 1 1. Mc. Bride and Ostroff 2003

Cessation and Cancer Prevention • Ten to 15 years after quitting, the ex-smoker may face the same low risk of developing cancer of the upper digestive tract, the lung, the pancreas, and the urinary tract as the nonsmoker. 1 • However, smoking cessation reduces risk for bladder cancer, but risk in ex-smokers remains higher than never-smokers for more than 20 years. 2 • Health care providers need to continue to be aggressive about diagnosing and treating tobacco use disorders at all ages as evidence indicates that smoking cessation decreases lung cancer risk. 3 1. Wynder and Hoffmann 1976; 2. Brennan et al. 2000; 3. Ebbert et al. 2003

Cessation in Cancer Survivors • Stopping smoking before middle age avoids more than 90% of the risk attributable to tobacco. 1 • Adult survivors of childhood cancer who smoke are at increased risk of developing cardiovascular disease, lung problems, and second malignancies, relative to the general public. 2 1. Peto et al. 2000; 2. Frobisher et al. 2008

Screening—A Must Do! • All patients testing for malignancy should also be screened for tobacco use. This could be an opportunity to prevent cancer. • Those who are already on treatment also need to be screened and encouraged to quit to improve their treatment efficacy and survival rate.

The most important health message a doctor can give to patients is to quit smoking.