Hard to quit smoking even after cancer is diagnosed

According to a new study many people with cancer continue to smoke after their diagnosis, even though they are told that smoking can significantly compromise the outcome of any treatment.

Dr. Ellen R. Gritz of the University of Texas M.D. Anderson Cancer Center in Houston, in a review of past research, found that even with the help of smoking cessation therapies, cancer patients often continued to smoke or fell back into the habit.

But it was also found that when smokers had help quitting they were more likely to succeed, though different studies have found a wide variation in success rates.

The authors say that in one study of lung cancer patients, 40 percent of those who went through an educational-type therapy were abstinent 6 weeks later, while a similar study found a success rate of only 21 percent.

Another trial found that "strong advice" about quitting from doctors seemed effective, with 70 percent of cancer patients staying abstinent for a year.

The findings, according to the researchers, show that smoking cessation therapy can help cancer patients, but more work is needed to figure out which therapies are best.

According to the researchers, there is plenty of evidence that quitting smoking after a cancer diagnosis has important benefits, regardless of whether the cancer is smoking-related.

Apparently smoking can dampen the effectiveness and worsen the side effects of cancer therapies, including surgery, radiation and chemotherapy, and studies have consistently found that patients who smoke have poorer survival rates, and a higher risk of cancer recurrence.

According to Gritz and her colleagues, research has also shown that cancer patients who stop smoking have a better quality of life, including better physical functioning and emotional well-being.

The researchers found however that only a few studies have tested smoking cessation therapies on cancer patients, and the evidence suggests that healthcare providers are not doing enough to encourage cancer patients to quit.

Gritz's team say that despite the importance of stopping smoking for all cancer patients, the diagnosis of cancer is underused as a teachable moment for smoking cessation.

The researchers believe there are special considerations when a cancer patient wants to quit smoking.

There are a range of therapies which include behavioral and educational techniques, nicotine gums and patches, and other drug treatments.

However some tumors and cancer therapies can limit those options, and certain other components of quitting, such as exercise and diet changes, may not be realistic for some patients.

Added to that is the fact that smokers with cancer may also be dealing with emotional problems, such as depression, anxiety and guilt, which can make quitting even more difficult.

The team at the M.D. Anderson Cancer Center say more studies are needed into the effectiveness of various cessation therapies for cancer patients, including those with tumors unrelated to smoking.

The study is published in the journal Cancer, January 1, 2006.