The Exchange

Commentary and Observations from
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Quitting Smoking When You Already Have Lung Cancer: Does It Matter?

Quitting Smoking When You Already Have Lung Cancer: Does It Matter?

Many patients feel that once they develop lung cancer, it is pointless to quit smoking. Smoking is one of the toughest addictions to break, and with the added stress of battling lung cancer it can be even more difficult. However, there are several significant benefits to quitting, especially for patients with early-stage, potentially operable disease.

When a patient is under evaluation for lung cancer surgery there are several risk factors to consider, such as age, smoking status, and the stage of the cancer. However, smoking status is a modifiable risk factor and can weigh heavily on a surgeon's decision to operate. We know that, in the long term, smoking cessation improves lung function. But in the short term, it can decrease mucus production and potentially impact an individual's ability to pursue surgery for lung cancer. One meta-analysis reports a decreased risk of postoperative respiratory complications by 23% in patients who quit 4 weeks prior to surgery, and a 47% decrease for those who quit 8 weeks prior to surgery.

What about patients who have metastatic disease? Again, there is often the feeling of, "if I am going to die anyway, why quit smoking?" We know that patients who do not smoke are better able to handle the toxicity of lung cancer treatments, like chemotherapy and radiationmost likely because they are overall healthier. Some non-randomized studies have looked at patients with metastatic lung cancer who quit smoking and found that their overall outcomes and survival were better than patients who did not quit smoking, though this has not yet been proven in a randomized, prospective study.

Smoking cessation is a very important message to convey to patients with lung cancer at any stage. Especially now with advances in cancer treatments that are helping patients live longer, smoking cessation may allow them to maintain a healthier life, and certainly can reduce their risk of developing further lung cancers.

  • Dobson Amato KA, Hyland A, Reed R, et al. Tobacco cessation may improve lung cancer patient survival. J Thorac Oncol. 2015;10:1014-1019.
  • Roberts R, Lewis K. Does smoking status after a diagnosis of lung cancer matter? Impact of quitting on 1 year survival. Eur Resp Journ. 2015;46(Suppl 59):OA269.
  • Wong J, Lam DP, Abrishami A, Chan MT, Chung F. Short-term preoperative smoking cessation and postoperative complications: a systematic review and meta-analysis. Can J Anaest. 2012;59:268-279.

Filed under: Oncology/Hematology, Pulmonary Medicine, Substance Abuse

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