Tobacco Use May Worsen MPN Symptoms

Patients with a myeloproliferative neoplasm who smoked tended to have worse quality of life than those who did not.

Patients with myeloproliferative neoplasms (MPNs) who smoke tend to have poorer quality of life compared to those with an MPN who don’t smoke, according to a study published in BMC Cancer.

The researchers analyzed an internet-based survey of 435 patients with MPNs who reported on their demographics, disease characteristics, tobacco habits and opinions about tobacco use, as well as MPN-related symptoms reported through the 10-item version of the Myeloproliferative Neoplasms Symptom Assessment Form.

Tobacco Increases MPN Symptom Severity

“Overall, current and former users of tobacco feel worse and have lower quality-of-life scores than their non-smoking MPN counterparts,” study author Dr. Holly L. Geyer, hospital and internal medicine practitioner at the Mayo Clinic, said in an interview with CURE®.

Current or former smokers had worse levels of fatigue and inactivity and more frequently experience early satiety and concentration difficulties than never smokers. Geyer explained that fatigue, appetite suppression and worse functional status are common effects seen in tobacco users without cancer, but those with an MPN can feel it to a worse degree.

“Among malignancies, the MPN disorders have one of the more challenging symptom burden profiles to deal with, so the addition of tobacco-induced symptoms only worsens their functional status,” Geyer said.

People who smoke were also more likely to have issues with other substances and differing viewpoints on their cancer.

“Those with a tobacco use history are also more likely to have problems with other addictive substances such as alcohol, and most don’t believe that tobacco use raised their risk for developing cancer,” Geyer said, noting that she was surprised to see that smokers were more likely to feel that vaping was safer than smoking cigarettes. “The reality is that both result in lung damage, increase your risk of blood clots and can lead to systemic inflammation that increases cancer-related risks.”

Quitting Is Possible

Patients with MPNs can improve their quality of life – and potentially the length of their life— by quitting smoking. Geyer said that previous research has shown that tobacco cessation can improve symptoms over time, but she knows that quitting is not always easy.

Patients with an MPN should reach out to their health care team if they are having difficulty quitting. Geyer also admitted that clinicians can do a better job in broaching the topic with their patients – especially as smoking can exacerbate cancer-related symptoms.

“At the end of the day, any substance that enters the body should be fair game to bring up with a health care provider. MPN patients should feel empowered to address their tobacco use openly and ask about what additionally risks it may impose, as well as treatments that may be useful,” she said. “With so many useful medications on the market, helping someone to stop smoking is one of the most important health care interventions a provider can make.”

Nationally, the U.S. has made great strides in decreasing tobacco use, and Geyer hopes to continue in that direction.

“Greater education and awareness of the harmful effects of tobacco use has had a powerful impact on people’s decisions to quit,” she said. “It’s our hope that studies such as this one prod both patients and providers to consider the harmful impacts of the drug in hematological malignancies and prioritize addressing it at regular intervals.”

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