The Effect of Cigarette Smoking on Cancer Treatment–Related Side Effects

Abstract

After completing this course, the reader will be able to:1. Describe the influence of cigarette smoking on side effects during cancer treatment and following the end of cancer treatment.2. Identify areas in your practice in which smoking status can be assessed on a regular basis and devise a plan for disseminating cessation information and free cessation aids.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBackground. Cigarette smoking has long been implicated in cancer development and survival. However, few studies have investigated the impact of smoking on symptom burden in cancer survivors during treatment and at survivorship stage. This study examines the influence of cigarette smoking on side effects among 947 cancer patients during and 6 months following treatment. Methods. Patients diagnosed with cancer and scheduled to receive chemotherapy and/or radiation therapy reported on current smoking status (yes, no) and total symptom burden [the sum of 12 common symptoms (fatigue, hair loss, memory, nausea, depression, sleep, pain, concentration, hot flashes, weight loss, skin problems, and dyspnea) scored on an 11-point scale ranging from 0 ‫؍‬ "not present" to 10 ‫؍‬ "as bad as you can imagine"] during treatment and at 6-month follow-up. The adjusted mean total symptom burden by smoking status was determined by

Randomized trial of a presurgical scheduled reduced smoking intervention for patients newly diagnosed with cancer.

“…Continued smoking by tobacco dependent cancer patients is associated with greater risk of recurrence (Fleshner et al, 1999; Kenfield, Stampfer, Chan, & Giovannucci, 2011), reduced survival (Murin & Inciardi, 2001; Parsons, Daley, Begh, & Aveyard, 2010; Waggoner et al, 2006; Warren, Kasza, Reid, Cummings, & Marshall, 2012) and quality of life (Garces et al, 2004; Peppone et al, 2011); and an increased risk of peri-operative complications during treatment(Dresler, Bailey, Roper, Patterson, & Cooper, 1996; Moller, 2006; Theadom & Cropley, 2006; Warner, 2006). …”

Smoking during radiotherapy for head and neck cancer and acute mucosal reaction

“…Smokers tended to be younger than non-smokers, which is consistent with another study that reported that patients who smoked during cancer radiotherapy tended to be younger than non-smokers. 19 We were unable to control for the potential confounding effects of other patient-related factors, such as alcohol use and buccal and dental hygiene status because this information was not collected. However, other studies have suggested that smokers have less-favourable baseline characteristics, such as socio-demographic characteristics (lower educational level, less familial support, poorer self-rated baseline health status), which increase their risk of developing treatment-related complications.…”

Attitudes of oncology healthcare practitioners towards smoking cessation: A systematic review of the facilitators, barriers and recommendations for delivery of advice and support to cancer patients

“…In radiotherapy for prostate cancer smoking is associated with an increased risk of experiencing long-term bowel and anal-sphincter region related side effects 52 . Across cancer sites, non-smokers have been shown to suffer a significantly reduced burden of symptoms after radiotherapy or chemotherapy 53 . Thus, smoking cessation in radiotherapy patients should be encouraged by practitioners for all patients, not just those with an aetiological tobacco associated cancer, as smoking can significantly increase sideeffects 11 , reduce quality of life 9,10 and prognosis in these patients 12,13 .…”

“…Across cancer sites, non-smokers have been shown to suffer a significantly reduced burden of symptoms after radiotherapy or chemotherapy 53 . Thus, smoking cessation in radiotherapy patients should be encouraged by practitioners for all patients, not just those with an aetiological tobacco associated cancer, as smoking can significantly increase sideeffects 11 , reduce quality of life 9,10 and prognosis in these patients 12,13 . Informing therapeutic radiographers of the evidence and improving their knowledge in this area is likely to facilitate delivery of smoking cessation to these patients 41 .…”

“…However, cancer patients also stand to benefit significantly from smoking cessation. Smoking contributes to a worse quality of life 9,10 after diagnosis and is associated with worse side effects from chemotherapy and radiotherapy 11 . Continued smoking is also associated with higher mortality rates 12,13 , recurrence of disease 14 and increased incidence of a second primary cancer 15 .…”