Smoking Cessation May Boost Survival in Patients with Head and Neck Cancer

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Patients who are looking to quit smoking to better their survival and health outcomes should talk to their health care team about different methods to do so, an expert said.

Smoking cessation led to improved overall and cancer-specific survival in patients with head and neck squamous cell carcinoma, according to recent study results.

“These results emphasize the importance and priority of immediate smoking cessation for better outcomes in (patients with) head and neck cancer,” said Dr. John Lee, lead author on the study and associate professor in the department of otolaryngology head and neck surgery at the University of Toronto in Canada, in an interview with CURE®.

Research on head and neck cancer outcomes show that outcomes tend to be better in patients who quit smoking.

Research on head and neck cancer outcomes show that outcomes tend to be better in patients who quit smoking.

It has been previously reported that tobacco is a risk factor for developing head and neck squamous cell carcinoma; however, data on prognostic associations with smoking cessation, or quitting smoking, are limited. Of note, about 50% of patients report that they were unaware of the negative impact of continued smoking had on treatment outcomes, Lee highlighted.

So, Lee and other researchers sought to evaluate the effect smoking cessation had on survival outcomes in patients with head and neck cancer.

Results, which were published in the journal Cancer, demonstrated that former smokers (841 patients) had a reduced risk of overall mortality compared to those who were current smokers (931 patients). Specifically, those who quit more than 10 years before receiving a diagnosis had the most improved overall survival.

Moreover, the five-year rates of head and neck cancer-specific and noncancer specific deaths were 16.8% and 9.4%, respectively. Former smokers had a reduced cancer-specific mortality compared with nonsmokers, but there was no difference in noncancer-specific mortality. And not smoking for more than 10 years was associated with decreased cancer-specific death compared with current smoking.

A longer duration of nonsmoking was also significantly associated with a reduced overall and cancer-specific death in patients who received primary radiation.

Many patients have an attitude of quitting when something bad happens — for example receiving the diagnosis. But quitting prior to a diagnosis can result in a better chance of surviving head and neck cancer, Lee said.

He also noted that over 40% of patients included in this study were still smoking after receiving a diagnosis, highlighting the need for patients to have access to better resources, awareness and education of the harm smoking can do during a diagnosis.

“I think one, it's important for patients to be informed of this kind of information at the time of diagnosis, as well as for health care providers to provide formal education to allow accessible smoking cessation programs during a patient's cancer care,” he said.

For patients who are looking to quit smoking to better their outcomes and health, Lee suggested the first step is to take ownership and be willing to really want to do it. Patients should seek help from both their oncology team and their primary care physicians, as there are effective methods such as medications and behavioral support.

“I think ultimately quitting smoking is an initiative that need to be taken ownership by the patient,” he concluded.


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