Study: Do more to help patients quit smoking

Author: Mary Wade Burnside

A survey of cancer patients being treated at the Mary Babb Randolph Cancer Center indicates that many of the smokers did not quit the habit in light of their diagnosis and some of them were not even advised to do so by their doctors.

“It absolutely benefits patients to quit,” said Dr. Jame Abraham, chief of oncology at WVU Hospitals and the medical director of the Mary Babb Randolph Cancer Center in Morgantown. “No. 1, we know that smoking can potentially alter the effectiveness of chemotherapy.

“No. 2, smoking can cause many other conditions, including lung cancer and COPD (chronic obstructive pulmonary disease), and smoking can increase the chance of getting pneumonia and lung disease, which can complicate the ability to take the treatment.”

The study was the idea of Lola Burke, now a second-year medical student who performed much of the survey work, Abraham said.

Burke sent surveys to 1,000 cancer patients, and 200 of them responded. Of the 200 who responded, 52 percent had a history of smoking, but only 20 percent had been actively smoking at the time of the diagnosis, Abraham said.

Of the active smokers, 44 percent quit while 56 percent did not, Abraham said.

“Another thing we found was that 40 percent were not told by the doctors to quit,” he added. “They didn’t even hear this from their doctors or their health-care provider.”

Bruce Adkins, director of the Division of Tobacco Prevention for the West Virginia Bureau for Public Health, has teamed up with Marshall University’s Joan C. Edwards School of Medicine in an effort to offer training to physicians who would teach them how to counsel patients to quit smoking.

“We started doing some provider training about two and a half year ago,” he said. “It’s a tough addiction to break. You have to keep reinforcing it. People don’t usually quit smoking the first time they attempt to quit. The average number of times it takes someone to quit using tobacco is eight to 10 times.”

Staff members from Marshall’s School of Medicine travel throughout the state offering a three-hour course to physicians, covering topics such as cessation counseling, spit tobacco, smoking and pregnancy, and the pharmacotherapy of tobacco cessation, Adkins said.

In 2007, the Centers for Disease Control and Prevention (CDC) reported that West Virginia had the second-highest rate of adult smokers in the United States at 25.7 percent, second to Kentucky at a rate of 28.6 percent.

The findings of the study at the Mary Babb Randolph Cancer Center, which have been released in this month’s edition of Journal of Oncology, published by the American Society of Clinic Oncology, illustrate that more must be done in order to help cancer patients quit, Abraham said.

“Many times, that person has been smoking for a long time,” he said. “That addictiveness is so high, so you can’t just walk away from this in one day.”

The news came during the same week that the CDC released a report in its Morbidity and Mortality Weekly Report stating that Kentucky and West Virginia have the highest death rates from smoking.

It also comes during the same month that actor Patrick Swayze, undergoing treatment for pancreatic cancer, admitted that he still smokes.

“We do see similar behavior all the time,” Abraham said of Swayze’s admission. “But I’m not going to blame the patient. Last week, I was talking to a patient who, because of her cancer treatment has lost her hair, and she said, ‘I know it looks ridiculous to smoke.’ She knows that, but she’s still smoking. It’s more complicated than that.”

The study was filled out by people being treated for a variety of different cancers, not just those that generally have been associated with cigarette smoking, which include cancer of the lungs, head and neck, bladder, stomach and pancreas.

“Many times, some early-stage cancer patients get cured from the primary cancer and then come back with a second cancer,” Abraham said. “We had a stage-one breast cancer patient. I gave her the treatment and I told her, ‘You’re going to be fine. There is a 90 percent chance that it’s not going to come back.’

“But she was an active smoker and two years later, she had a large mass in her lung and died of lung cancer.”

The situation frustrates anti-smoking activist Adkins, who smoked in college and was treated for cancer of the tongue three years ago, about 30 years after he quit his smoking habit.

When he had cancer, Adkins said, radiation treatments were very uncomfortable, and he could not imagine smoking during that time period.

“I could barely swallow. I could barely eat. Nothing tasted good. Everything was yucky,” he said. “Smoking could not have made that better. It could only have made things worse if I was a smoker.”