Quitting smoking after cancer diagnosis prolongs life | Health

Gary Davis, 69, smoked most of his adult life and struggled to give up cigarettes, but found his final motivation after he was diagnosed with lung cancer and told by his surgeon that he had to stop or he would not be able to undergo the necessary intervention.

When he returned home after this visit, the smoking cessation medication he had ordered was waiting for him.

“I said, that’s right, that must be a sign telling me, ‘Stop smoking,'” Davis said. “And I did.”

Not only did it improve his health, but its rapid action potentially added years to his life despite having cancer.

A new study found that those, like Davis, quit smoking within three months of their cancer diagnosis experienced a 26 percent reduction in premature deaths compared to those who continued smoking and that these smokers lived on average almost two years longer. As November 21 approaches, the annual Great American Smokeout Day, when smokers are urged to quit smoking for at least one day, new evidence shows it has a powerful effect on health, even in patients suffering from cancer.

It also provides new evidence that doctors and cancer centers need to work harder to help their patients kick the habit.

The study in JAMA Oncology examined more than 4,500 current smokers who were diagnosed with cancer at MD Anderson Cancer Center in Houston and then referred for smoking cessation therapy, between January 2006 and March 2022. The vast majority of those who successfully to quit smoking within six months those who received the diagnosis lived almost two years longer than those who continued smoking and longer than those who quit later.

“Quitting smoking after a cancer diagnosis can really improve cancer survival overall, and the earlier someone quits in their cancer survivorship journey, the better,” said Dr. Graham Warren, vice president of radiation oncology research at the Institute. Hollings Cancer Center at the Medical University of South Carolina and lead author of the study.

There is also a danger in not giving up, he says. Continuing to smoke increases the risk of cancer treatment failure by about 60 percent, he said. Cigarette smoke contains chemicals that activate cancer pathways and can increase resistance to treatments like radiation or chemotherapy.

“If you remove cigarette smoke, these tumors may become more responsive to treatment,” Warren said. “So biologically it has an effect on the effectiveness of our traditional cancer treatments.”

Despite this evidence, it has been difficult over the years to convince clinicians, cancer centers and patients that quitting smoking should be a priority, he said. People know that smoking leads to cancer, but after diagnosis, they might think it no longer matters and “that assumption is wrong,” Warren said.

In 2017, for example, according to the National Health Survey, nearly one in five survivors of smoking-related cancer still smoked. Recognizing that too few cancer patients were receiving help to quit smoking, that same year the National Cancer Institute launched the Cancer Center Cessation Initiative. It was part of the larger Cancer Moonshot program launched in 2016 and the smoking cessation initiative now includes 52 cancer centers across the country, the NCI said.

Warren and others have been pushing centers for years to include coordinated smoking cessation efforts. The American College of Surgeons Commission on Cancer has a program to encourage treatment centers to ask patients about their smoking status and 730 now have a program in place to do so and improve follow-up. But only a quarter of these programs had a cessation expert or counselor as part of their cancer clinical team, the commission reported in 2023.

The fight against smoking and cancer now extends beyond borders. The Canadian Partnership Against Cancer has worked to increase smoking cessation programs in cancer centers from 26 per cent in 2016 to 95 per cent in 2022, Warren said.

The JAMA study was conducted at MD Anderson because of its comprehensive smoking cessation program and its long, careful follow-up of these patients. But MUSC also has a robust program developed over the past decade that serves not only cancer patients but also inpatients, Warren said. It provides support to patients in several ways: patients can receive in-person bedside counseling or be referred to smoking cessation counselors, they can receive pharmaceutical help or get help via a quitline to smoke, he said.

This has been very effective and has also been beneficial to the health care system, Warren said. An analysis found the program reduced readmissions as well as the cost of hospital admissions, he said.

“I’m very proud of the work we do here,” Warren said.

The work also shows that simply quitting smoking could be considered a cancer treatment due to its added survival benefits, without any downside to the patient.

“Quitting smoking is probably one of the cheapest and most effective ways to improve cancer survival and treatment, without additional toxicity,” Warren said.

Davis, the lung cancer patient, also benefited from the care of a conscientious doctor. Because Davis worked on commercial HVAC systems, his doctor was concerned about his exposure to asbestos and other toxic chemicals as well as his smoking, and insisted that a chest X-ray be performed annually. This then turned into a scan every year. It falls within national guidelines that require low-dose scanning annually for people aged 50 to 80 with a 20-year pack history, or one pack per day for 20 years, who are currently smokers or who have stopped in recent years. the last 15 years.

Two years ago, Davis had a CT scan that showed “small spots” on his lower right lung, which were removed.

“That’s how I found it so early,” he said.

Quitting soon after will probably help him survive. But just not smoking anymore makes a difference for him.

“You start to feel better,” Davis said. “I didn’t realize how much it hurt me until I quit smoking. I highly recommend it.”