World Lung Cancer Day 2021: Smoking Cessation Is An Integral Part of Lung Cancer Treatment
World Lung Cancer Day is observed on August 1. Smoking is one of the major modifiable risk factors that can increase the risk of lung cancer. Here's all you need to know.
World Lung Cancer Day tries to raise awareness about lung cancer on August 1 every year
A huge number of tobacco-related cancers are recorded every year in India. As many as 27 per cent of cancer cases were caused due to tobacco consumption, as per data from the National Cancer Registry of India. In India nearly 70,000 patients are diagnosed with this dreaded disease every year and tobacco use remains the single most important and avoidable risk factor (80-90%) for the same. Studies have shown that many patients continue to smoke even after receiving a cancer diagnosis. Although some patients are determined to quit, some feel it is now futile since the damage is already done. Nonetheless, it is important to emphasize the adoption of formal quitting programmes for every smoker/tobacco user who has been diagnosed with cancer to avoid treatment related side effects, avoid worse outcomes in terms of cancer related survival and also prevent a possibility of a second cancer and other health related issues.
Adverse treatment outcomes in lung cancer patients with all modalities of treatment-
Surgery- There are more chances of lung infections during postoperative period in smokers; this has been proven in various studies. Moreover, it is known that the post-surgical wound healing in patients who continue to smoke during their treatment has been poor.
Radiation Therapy- Smoking may cause hypoxia, a lack of oxygen in the body or part of the body. Hypoxia may produce poorer outcomes from radiation therapy. Moreover, the side effects of radiation therapy also increase in a patient who continues to smoke.
Chemotherapy, Immunotherapy and Targeted treatment- Toxins in tobacco smoke may cause cellular changes that affect how chemotherapy drugs are metabolized, potentially making them more toxic or less effective. Also, because of decreased immunity in smokers, the benefits of chemotherapy and immunotherapy are diminished. Targeted therapies can have more adverse effects in patients who continue to smoke.
Treatment delays- A higher symptom burden because of lung damage by smoking can lead to interruptions in treatment, reductions in dosages, and delays in therapy. Treatment interruptions and dosage reduction can, in turn, compromise treatment efficacy, resulting in lower survival rates.
Smoking can result in increased recurrence and even a new cancer can come up
In patients where the lungs are already affected there is a possibility of field cancerization (where the cancer seed can always grow in an unhealthy soil) and this results in high death rates because these are cancers highly resistant to treatment.
Barriers in quitting- Many people with cancer do not want to tell their doctor about their tobacco use. There may be several reasons for this, including:
- Concern that the doctor may judge them
- Concern that they may receive less support for their cancer diagnosis
- Believe that quitting after a diagnosis of cancer is pointless
- Believe that using tobacco can help relieve the stress of a cancer diagnosis
Instead, talking about tobacco use with their doctor will help in better patient support. Tobacco products contain nicotine, which is addictive. Addiction makes it hard to stop smoking, even if one is motivated to quit, therefore medical assistance is always important. It is never too late to quit smoking and the health care team would help the patient to achieve this goal.
(Dr Peush Bajpai MD, DM, ECMO Consultant and Head, Department of Medical Oncology, HCMCT Manipal Hospital, New Delhi)
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