New research examines survival benefits for cancer patients who quit smoking within the first six months after diagnosis, compared to those who quit later.
RT’s Three Key Takeaways:
- Immediate Survival Benefit: Quitting smoking within six months after a cancer diagnosis adds an average of two years to patient survival.
- Broad Applicability Across Cancers: The study found improved survival benefits from smoking cessation across various cancer types, not just tobacco-related cancers, emphasizing its universal importance in cancer care.
- Call for Consistent Support: While most cancer centers inquire about smoking status, only 40% provide cessation assistance, underscoring the need for all centers to implement evidence-based programs to help patients quit, according to researchers.
Quitting smoking within six months after a cancer diagnosis adds an average of two years to a patient’s life.
With this information in hand, cancer centers have an obligation to offer evidence-based smoking cessation to all patients, says Graham Warren, MD, PhD, vice-chair for research in the Department of Radiation Medicine at Medical University of South Carolina (MUSC), in a news release. He’s also the Mary Gilbreth Endowed Chair of Oncology, an MUSC Hollings Cancer Center researcher, and senior author of a new paper that demonstrates a broad survival benefit of using evidence-based smoking cessation to help patients quit smoking as soon as possible after a cancer diagnosis.
“This is a survival benefit that we can achieve now. It isn’t something that we need to wait 10 years for trial results. If we miss patients now, well, they’ve missed the benefit that they would gain from it,” says Warren in the release. “So there’s an urgent responsibility to make this work. It is important to make sure that we give everyone evidence-based care specifically to help them improve survival. This isn’t an optional thing.”
The study is published in JAMA Oncology.
Benefit of Quitting Smoking in Cancer Patients
It’s well known that smoking after a cancer diagnosis decreases the effectiveness of treatment and increases the likelihood of certain side effects or complications. And some previous papers have looked at the survival benefit of quitting smoking in specific subgroups of cancer patients, like lung cancer patients.
In this paper, Warren and his collaborators at MD Anderson Cancer Center were able to use data from the Tobacco Research and Treatment Program at MD Anderson to look at long-term survival across more than 4,500 patients with a wide variety of cancers.
The records from this program were valuable because they regularly note a patient’s current smoking status and use of a structured evidence-based tobacco treatment program. Too often, Warren says, cancer centers ask about a patient’s smoking status at diagnosis but don’t follow up throughout treatment to update the electronic health record.
With the detailed records from the Tobacco Research and Treatment Program, the researchers were able to subdivide patients into three groups: those who stopped smoking within six months of diagnosis, those who stopped between six months and five years after diagnosis, and those who stopped more than five years after diagnosis. Quitting smoking after a cancer diagnosis improved survival across cancer as a whole, with the largest benefit among patients who quit within six months following diagnosis.
David Marshall, MD, chair of radiation medicine and medical director of the Clinical Trials Office at Hollings Cancer Center, says the clear benefit of smoking cessation after diagnosis across all types of cancer places particular emphasis on the need to improve clinical treatment approaches for all patients. Marshall’s expertise is in prostate cancer and clinical trials, and he noted the impact of smoking on outcomes in prostate cancer.
“Most prostate cancer patients don’t die of prostate cancer. It is often smoking-related conditions that contribute to patient deaths,” he says in a release.
Quitting smoking even among patients with non-tobacco-related cancers can be one of the biggest contributors to improving overall survival.
Cementing the Survival Benefit
Warren says these data likely represent the new gold standard cementing the survival benefit for supporting smoking cessation programs at cancer centers. Unfortunately, he says, while up to 90% of patients are asked about smoking, only about 40% of centers provide smoking cessation assistance.
“This isn’t like developing a new targeted agent. You don’t need new protocols or to buy new drugs,” he says in a release. “If you understand the importance of this, you can start doing it this afternoon. The evidence is there. The treatments are there. It’s just a matter of getting clinicians to put it into practice and patients receiving evidence-based treatment.”
Raymond N. DuBois, MD, PhD, director of MUSC Hollings Cancer Center, noted the significance for all types of cancer. “This research shows in a very clear and straightforward manner what clinicians have often observed: that their patients who continue to smoke fare worse than those who are able to stop smoking,” DuBois says in a release. “This is a significant finding for people dealing with any type of cancer diagnosis, not just lung cancer, and for their doctors. Also, we have known that continued smoking after a cancer diagnosis weakens the immune system, making it harder for the body to fight off cancer cells.”
K. Michael Cummings, PhD, a colleague at Hollings with an extensive tobacco research record who has collaborated with Warren on other projects but not this paper, says the paper shows the clinical necessity of offering smoking cessation programs.
“Patients and family members need to be informed of the benefits of stopping smoking,” he says in a release. “Additionally, patients who smoke need to be given real help to stop smoking, recognizing that getting off cigarettes is not easy to do. Cigarette addiction is a chronic relapsing disorder so one-off interventions for patients are inadequate.”
