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A review of the effects of tobacco smoking on cancer treatment: smoking cessation intervention should be integrated into the cancer care continuum. JOURNAL OF RADIOTHERAPY IN PRACTICE 2019. [DOI: 10.1017/s1460396919000360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AbstractBackground:The adverse health effects associated with smoking tobacco have been well investigated, and its detrimental effects on cancer treatment outcomes, efficacy and quality of life (QOL) for cancer patients have also been well documented. Tobacco smoke contains many thousands of chemicals, including a plethora of carcinogens, and the exposure of human cells to these carcinogens, and their metabolic activation, is the main mechanism by which smoking-related cancer is initiated.Materials and Methods:This paper reports on a narrative review of recent studies in the field of effects of tobacco smoking on cancer treatment, including the effects of carcinogens in smoke on carcinogenesis, cell mutations and the immune system. The health effects of smokeless tobacco, effects of tobacco smoking on cancer treatment, and its impact on surgery, radiation therapy and chemotherapy are reported. The potential risks of second primary cancers or recurrence from tobacco use, the effects of second-hand smoking and cancer treatment, the impact of smoking on the QOL after cancer treatment and the need to integrate smoking cessation programs into the cancer care continuum are also reported.Conclusions:Tobacco use has a direct impact on cellular function by inhibiting apoptosis, stimulating proliferation and decreasing the efficacy of cancer treatment; therefore, quitting its use has the potential to improve treatment response rates and survival, as well as reduces the risk of developing second cancers and potentially improves the QOL after treatment. Smoking cessation is one of the most important interventions to prevent cancer and is also essential after the diagnosis of cancer to improve clinical outcomes. Due to the numerous benefits of smoking cessation, it should become a critical component of the cancer care continuum in all oncology programs – from prevention of cancer through diagnosis, treatment, survivorship and palliative care. Evidence-based smoking cessation intervention should be sustainably integrated into any comprehensive cancer program, and the information should be targeted to the specific benefits of cessation in cancer patients.
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McConnell DD, Carr SB, Litofsky NS. Potential effects of nicotine on glioblastoma and chemoradiotherapy: a review. Expert Rev Neurother 2019; 19:545-555. [PMID: 31092064 DOI: 10.1080/14737175.2019.1617701] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Introduction: Glioblastoma multiforme (GBM) has a poor prognosis despite maximal surgical resection with subsequent multi-modal radiation and chemotherapy. Use of tobacco products following diagnosis and during the period of treatment for non-neural tumors detrimentally affects treatment and prognosis. Approximately, 16-28% of patients with glioblastoma continue to smoke after diagnosis and during treatment. The literature is sparse for information-pertaining effects of smoking and nicotine on GBM treatment and prognosis. Areas covered: This review discusses cellular pathways involved in GBM progression that might be affected by nicotine, as well as how nicotine may contribute to resistance to treatment. Similarities of GBM pathways to those in non-neural tumors are investigated for potential effects by nicotine. English language papers were identified using PubMed, Medline and Scopus databases using a combination of keywords including but not limited to the following: nicotine, vaping, tobacco, e-cigarettes, smoking, vaping AND glioblastoma or brain cancer OR/AND temozolomide, carmustine, methotrexate, procarbazine, lomustine, vincristine, and neural tumor cell lines. Expert opinion: Understanding the impact of nicotine on treatment and resistance to chemotherapeutics should allow physicians to educate their patients with GBM with evidence-based recommendations about the effects of continuing to use nicotine-containing products after diagnosis and during treatment.
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Affiliation(s)
- Diane D McConnell
- a Division of Neurological Surgery , University of Missouri School of Medicine , Columbia , MO , USA
| | - Steven B Carr
- a Division of Neurological Surgery , University of Missouri School of Medicine , Columbia , MO , USA
| | - N Scott Litofsky
- a Division of Neurological Surgery , University of Missouri School of Medicine , Columbia , MO , USA
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Abdel-Rahman O. Impact of current versus former smoking status on the outcomes of non-metastatic non-small cell lung cancer treated with upfront surgery; findings from the National Lung Screening Trial. Expert Rev Respir Med 2019; 13:585-591. [PMID: 31055993 DOI: 10.1080/17476348.2019.1615887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: To evaluate the impact of current versus former smoking status on the outcomes of non-metastatic non-small cell lung cancer (NSCLC) treated with upfront surgery. Methods: This is a post-hoc analysis of patients diagnosed with NSCLC, stage I-III within the National Lung Screening Trial (NLST). Kaplan-Meier analysis was used to delineate the impact of smoking status on overall survival. Moreover, Cox regression analyses were utilized to assess factors predicting overall and lung cancer-specific survival. Results: A total of 773 patients were included in the current study. Former smokers (at the time of randomization of the NLST study) were 338 patients while current smokers were 435 patients. For overall survival, former smokers have better outcomes compared to current smokers (P = 0.023). Within multivariate Cox regression analysis, the following factors were predictive of worse overall survival: older age (P = 0.037), male gender (P = 0.022), current smoking (P = 0.022), advanced stage (P < 0.001) and preexisting stroke (P = 0.015). Likewise, the following factors were predictive of worse lung cancer-specific survival in multivariate Cox regression analysis: current smoking (P = 0.009) and advanced stage (P < 0.001). Conclusions: Among patients with early-stage NSCLC treated with upfront surgery, current smokers have worse overall and lung cancer-specific survival compared to former smokers. Expert opinion: Among patients with non-metastatic NSCLC treated with upfront surgical resection, current smokers have worse overall, lung cancer-specific and progression-free survival compared to former smokers. Smoking cessation counseling should be incorporated into management strategies of early stage NSCLC.
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Affiliation(s)
- Omar Abdel-Rahman
- a Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt.,b Department of Oncology , University of Calgary, Tom Baker Cancer Centre , Calgary , Alberta , Canada
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Marrufo AS, Kozower BD, Tancredi DJ, Nuño M, Cooke DT, Pollock BH, Romano PS, Brown LM. Thoracic Surgeons' Beliefs and Practices on Smoking Cessation Before Lung Resection. Ann Thorac Surg 2019; 107:1494-1499. [PMID: 30586576 PMCID: PMC11292109 DOI: 10.1016/j.athoracsur.2018.11.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 11/24/2018] [Accepted: 11/26/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Smoking is a risk factor for complications after lung resection. Our primary aim was to ascertain thoracic surgeons' beliefs and practices on smoking cessation before lung resection. METHODS An anonymous survey was emailed to 846 thoracic surgeons who participate in The Society of Thoracic Surgeons General Thoracic Surgery Database. RESULTS The response rate was 23.6% (n = 200). Surgeons were divided when asked whether it is ethical to require that patients quit smoking (yes, n = 96 [48%]) and whether it is fair to have their outcomes affected by patients who do not quit (yes, n = 87 [43.5%]). Most do not require smoking cessation (n = 120 [60%]). Of those who require it, the most common required period of cessation is 2 weeks or more. Most believe that patient factors are the main barrier to quitting (n = 160 [80%]). Risk of disease progression (39% vs 17.5%, p = 0.02) and alienating patients (17.5% vs 8.8%, p = 0.04) were very important considerations of those who do not require smoking cessation versus those who do. Only 19 (9.5%) always refer to a smoking cessation program and prescribe nicotine replacement therapy and even fewer, 9 (4.5%), always refer to a program and prescribe medical therapy. CONCLUSIONS Thoracic surgeons are divided on their beliefs and practices regarding smoking cessation before lung resection. Most believe patient factors are the main barrier to quitting and have concerns about disease progression while awaiting cessation. Very few surgeons refer to a smoking cessation program and prescribe nicotine replacement therapy or medical therapy.
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Affiliation(s)
- Angelica S Marrufo
- University of California Davis School of Medicine, Sacramento, California
| | - Benjamin D Kozower
- Division of Cardiothoracic Surgery, Washington University in St. Louis, St. Louis, Missouri
| | - Daniel J Tancredi
- Center for Healthcare Policy and Research, University of California Davis Health, Sacramento, California
| | - Miriam Nuño
- Department of Public Health Sciences, University of California Davis School of Medicine, Sacramento, California
| | - David T Cooke
- Section of General Thoracic Surgery, University of California Davis Health, Sacramento, California
| | - Brad H Pollock
- Department of Public Health Sciences, University of California Davis School of Medicine, Sacramento, California
| | - Patrick S Romano
- Center for Healthcare Policy and Research, University of California Davis Health, Sacramento, California; Department of Internal Medicine, University of California Davis Health, Sacramento, California
| | - Lisa M Brown
- Section of General Thoracic Surgery, University of California Davis Health, Sacramento, California.
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Leventakos K, Schwecke AJ, Deering E, Cathcart-Rake E, Sanh AC, Jatoi A. The Need to Prioritize and Re-prioritize Palliative Care Options: Smoking Cessation as a Case-in-Point. Curr Treat Options Oncol 2019; 20:33. [PMID: 30903460 DOI: 10.1007/s11864-019-0632-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OPINION STATEMENT Palliative care in cancer patients requires a continuous reprioritization of effort. This review describes the need for this reprioritization and uses smoking cessation as a case-in-point. The treatment of patients with metastatic non-small cell lung cancer has changed dramatically in the past few years. Interestingly, patients who had previously smoked now have an improved prognosis-for a variety of reasons. This review discusses this last observation in detail and raises the question of how forcefully we should advise smoking cessation in patients with incurable metastatic non-small cell lung cancer.
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Affiliation(s)
| | - Anna J Schwecke
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Erin Deering
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | | | - Anna C Sanh
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Aminah Jatoi
- Department of Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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Nicotine Induces Resistance to Erlotinib Therapy in Non-Small-Cell Lung Cancer Cells Treated with Serum from Human Patients. Cancers (Basel) 2019; 11:cancers11030282. [PMID: 30818860 PMCID: PMC6468898 DOI: 10.3390/cancers11030282] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 02/25/2019] [Indexed: 12/20/2022] Open
Abstract
Previously, we reported that nicotine reduces erlotinib sensitivity in a xenograft model of PC9, an epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI)-sensitive non-small-cell lung cancer cell line. The present study examined whether smoking induces erlotinib resistance in vitro. We assessed resistance to EGFR-TKIs by treating cancer cell lines with erlotinib, afatinib, or osimertinib, and serum collected from smokers within 30 min of smoking and that from a non-smoker as a control. We also assessed erlotinib resistance by treating PC9 cells exposed to serum from a smoker or a non-smoker, or serum from an erlotinib user. Treatment of the cancer cell lines with serum from smokers induced significant erlotinib resistance, compared with the control (p < 0.05). Furthermore, serum samples with a high concentration of cotinine (a nicotine exposure indicator) demonstrated stronger erlotinib resistance than those with low concentrations. Similar to the observations with erlotinib treatment of cell lines, the analysis of serum from erlotinib users revealed that smokers demonstrated significantly reduced sensitivity to erlotinib (p < 0.001). In conclusion, our present results support the hypothesis that smoking contributes to resistance to erlotinib therapy in non-small-cell lung cancer.
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Lee K, Oh EG, Kim S, Kim S. Symptom experiences and health‐related quality of life among non‐small cell lung cancer patients participating in clinical trials. J Clin Nurs 2019; 28:2111-2123. [DOI: 10.1111/jocn.14803] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Kyunghwa Lee
- Department of Nursing Yonsei University Graduate School Seoul Korea
| | - Eui Geum Oh
- Mo‐Im Kim Nursing Research Institute Yonsei University College of Nursing Seoul Korea
| | - Sanghee Kim
- Mo‐Im Kim Nursing Research Institute Yonsei University College of Nursing Seoul Korea
| | - Sang‐We Kim
- Department of Oncology, Asan Medical Center University of Ulsan College of Medicine Seoul Korea
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Derksen JW, Beijer S, Koopman M, Verkooijen HM, van de Poll-Franse LV, May AM. Monitoring potentially modifiable lifestyle factors in cancer survivors: A narrative review on currently available methodologies and innovations for large-scale surveillance. Eur J Cancer 2018; 103:327-340. [DOI: 10.1016/j.ejca.2018.06.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 05/28/2018] [Accepted: 06/05/2018] [Indexed: 12/11/2022]
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Gu F, He Y, Mao Y, Lu S, Zhao C, Li X, Zhou C, Hirsch FR. Risk factors for nicotine dependence in Chinese patients with lung cancer. J Int Med Res 2018; 47:391-397. [PMID: 30304970 PMCID: PMC6384457 DOI: 10.1177/0300060518802738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objective Smoking is a poor prognostic factor for lung cancer. Nicotine dependence remains the major cause of failure of smoking cessation. We investigated the risk factors for nicotine dependence in patients with lung cancer. Methods Eligible patients were identified from November 2014 to February 2015. Age, marital status, educational level, annual household income, occupation, histology of lung cancer, tumor stage, smoking status, neuron-specific enolase (NSE) level, drive gene mutations, sleep quality, and patient personality were assessed. Physical nicotine dependence was assessed by the Fagerstrom Test for Nicotine Dependence (FTND). Results In total, 202 smokers were included in this study. Univariate analysis showed that marital status and pain were significantly correlated with nicotine dependence. Pearson’s correlation analysis showed that age at the initiation of smoking, attempts to quit, NSE level, and sleep quality were significantly correlated with FTND scores. Conclusions Pain, more attempts to quit, and poorer sleep quality were significantly associated with nicotine dependence. These risk factors could help to prevent smoking in Chinese patients with lung cancer.
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Affiliation(s)
- Fen Gu
- 1 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Yayi He
- 1 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Yanjun Mao
- 1 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Shiwen Lu
- 1 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Chao Zhao
- 2 Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Xuefei Li
- 2 Department of Lung Cancer and Immunology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Caicun Zhou
- 1 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, No. 507 Zhengmin Road, Shanghai, People's Republic of China
| | - Fred R Hirsch
- 3 Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Yip R, Taioli E, Schwartz R, Li K, Becker BJ, Tam K, Htwe YM, Yankelevitz DF, Henschke CI. A Review of Quality of Life Measures used in Surgical Outcomes for Stage I Lung Cancers. Cancer Invest 2018; 36:296-308. [PMID: 30040490 DOI: 10.1080/07357907.2018.1474892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This review summarizes the literature on QoL in early stage lung cancer patients who underwent surgery. PubMed and PsycINFO were searched. Twelve articles from 10 distinct studies were identified for a total of 992 patients. Five QoL measures were used. One study reported only on pre-surgical QoL, six only on post-surgical QoL and three studies reported on both pre- and post-surgical QoL. Timing for the administration of post-surgical QoL surveys varied. The literature on QoL in Stage I non-small-cell lung cancer patients is very sparse. Additional research is needed to explore the impact of different surgical approaches on QoL.
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Affiliation(s)
- Rowena Yip
- a Department of Radiology, Icahn School of Medicine at Mount Sinai , New York , New York, USA
| | - Emanuela Taioli
- b Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai , New York , New York, USA
| | - Rebecca Schwartz
- b Institute for Translational Epidemiology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai , New York , New York, USA.,c Department of Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra-Northwell , Great Neck , New York, USA
| | - Kunwei Li
- a Department of Radiology, Icahn School of Medicine at Mount Sinai , New York , New York, USA.,d Department of Radiology , Fifth Affiliated Hospital of Sun Yat-sen University , Zhuhai , China
| | - Betsy J Becker
- e Department of Educational Psychology and Learning Systems, College of Education , Florida State University , Tallahassee , Florida, USA
| | - Kathleen Tam
- a Department of Radiology, Icahn School of Medicine at Mount Sinai , New York , New York, USA
| | - Yu Maw Htwe
- f Department of Internal Medicine , Kingsbrook Jewish Medical Center , Brooklyn , New York , USA
| | - David F Yankelevitz
- a Department of Radiology, Icahn School of Medicine at Mount Sinai , New York , New York, USA
| | - Claudia I Henschke
- a Department of Radiology, Icahn School of Medicine at Mount Sinai , New York , New York, USA
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Kaiser EG, Prochaska JJ, Kendra MS. Tobacco Cessation in Oncology Care. Oncology 2018; 95:129-137. [PMID: 29920482 PMCID: PMC7020252 DOI: 10.1159/000489266] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/13/2018] [Indexed: 01/22/2023]
Abstract
Globally, tobacco use is a major modifiable risk factor and leading cause of many forms of cancer and cancer death. Tobacco use contributes to poorer prognosis in cancer care. This article reviews the current state of tobacco cessation treatment in oncology. Effective behavioral and pharmacological treatments exist for tobacco cessation, but are not being widely used in oncology treatment settings. Comprehensive tobacco treatment increases success with quitting smoking and can improve oncological and overall health outcomes. This article describes the components of a model treatment program, which includes automatic referrals for all current tobacco users and recent quitters, motivational interviewing during initial and follow-up contacts, combined behavioral and pharmacological interventions for cessation, and systematic follow-up phone calls for relapse prevention.
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Affiliation(s)
- Emily G Kaiser
- PGSP-Stanford Psy.D. Consortium, Palo Alto, California, USA
| | - Judith J Prochaska
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Matthew S Kendra
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
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Amato KA, Reid ME, Bansal-Travers M, Ochs-Balcom HM, Cummings KM, Mahoney M, Marshall J, Hyland A. Patient Cessation Activity after Automatic Referral to a Dedicated Cessation Support Service. J Smok Cessat 2018; 13:78-86. [PMID: 31565082 PMCID: PMC6764779 DOI: 10.1017/jsc.2017.7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION We characterized tobacco use, cessation patterns, and patient satisfaction with a cessation support program at an NCI Designated Comprehensive Cancer Center following a mandatory tobacco assessment and automatic referral. METHODS A 3-month follow-up survey (via web, paper, or telephone) was administered between March 2013 and November 2013 for all patients referred to and contacted by a cessation support service, and who consented to participation three months prior to administration. Patients were asked about their perceived importance and self-efficacy to quit smoking, quit attempts, and satisfaction with the cessation service. RESULTS Fifty-two percent (257/499) of patients who participated in the cessation support service, and consented to be contacted again, completed a follow-up survey. Of those who participated, 9.7% were referred to the service as having recently quit tobacco (in the past 30 days) and 23.6% reported having quit at the time of first contact. At the 3-month follow-up, 48.1% reported being smoke-free for the previous seven days. When patients were asked about their experience with the cessation service, 86.4% reported being very or mostly satisfied with the service, and 64.3% reported that their experience with the service increased their satisfaction with the care received at the cancer centre. CONCLUSIONS Our findings suggest that recently diagnosed cancer patients are aware that quitting tobacco is important, are making attempts to quit, and are amenable to an opt-out automatic referral cessation support service as part of their cancer care.
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Affiliation(s)
- Katharine A. Amato
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York
| | - Mary E. Reid
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
| | | | - Heather M. Ochs-Balcom
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Martin Mahoney
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
| | - James Marshall
- Department of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute, Buffalo, New York
| | - Andrew Hyland
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York
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Perriot J, Underner M, Peiffer G, Dautzenberg B. [Helping smoking cessation in COPD, asthma, lung cancer, operated smokers]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:170-180. [PMID: 29748064 DOI: 10.1016/j.pneumo.2018.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 02/05/2023]
Abstract
Smoking is the cause of addictive behavior. Tobacco addiction is a chronic disease that makes difficult to stop smoking and leads to further use. Smoking is a risk factor for COPD, asthma and lung cancer; it may be the cause of severe perioperative complications. This finding justifies that smokers benefit from advice of stopping smoking and smoking cessation assistance. Helping patients to stop smoking increases the chances of quitting, improves the prognosis of tobacco-related diseases, the effectiveness of their treatments and the quality of life of the patients. This article updates the modalities of smoking cessation assistance in smokers with COPD, asthma and lung cancer in operated patients. The goal of the management must be the complete cessation of tobacco smoke intoxication, which alone reduces tobacco mortality.
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Affiliation(s)
- J Perriot
- Dispensaire Emile-Roux, CLAT63, centre de tabacologie, 11, rue Vaucanson, 63100 Clermont-Ferrand, France.
| | - M Underner
- Centre hospitalier Henri-Laborit, unité de recherche clinique, 86000 Poitiers, France
| | - G Peiffer
- Service de pneumologie, CHR Metz-Thionville, 57038 Metz, France
| | - B Dautzenberg
- Groupe hospitalier Pitié-Salpêtrière, AP-HP, 75013 Paris, France
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Lim C, Cohn JR, Cohn JA. Can a diagnosis of bladder cancer motivate positive lifestyle changes-and prevent recurrent disease? Transl Androl Urol 2018; 7:S242-S245. [PMID: 29928624 PMCID: PMC5989117 DOI: 10.21037/tau.2018.04.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Caitlin Lim
- Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA
| | - John R Cohn
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Korman Respiratory Institute, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joshua A Cohn
- Department of Urology, Einstein Healthcare Network, Philadelphia, PA, USA.,Department of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
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Nishinarita N, Igawa S, Kasajima M, Kusuhara S, Harada S, Okuma Y, Sugita K, Ozawa T, Fukui T, Mitsufuji H, Yokoba M, Katagiri M, Kubota M, Sasaki J, Naoki K. Smoking History as a Predictor of Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Patients with Non-Small Cell Lung Cancer Harboring EGFR Mutations. Oncology 2018; 95:109-115. [DOI: 10.1159/000488594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 03/19/2018] [Indexed: 11/19/2022]
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Alton D, Eng L, Lu L, Song Y, Su J, Farzanfar D, Mohan R, Krys O, Mattina K, Harper C, Liu S, Yoannidis T, Milne R, Brown MC, Vennettilli A, Hope AJ, Howell D, Jones JM, Selby P, Xu W, Goldstein DP, Liu G, Giuliani ME. Perceptions of Continued Smoking and Smoking Cessation Among Patients With Cancer. J Oncol Pract 2018; 14:e269-e279. [PMID: 29676948 DOI: 10.1200/jop.17.00029] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Continued smoking after a cancer diagnosis leads to poorer treatment outcomes, survival, and quality of life. We evaluated the perceptions of the effects of continued smoking on quality of life, survival, and fatigue among patients with cancer after a cancer diagnosis and the effects of these perceptions on smoking cessation. PATIENTS AND METHODS Patients with cancer from all disease subsites from Princess Margaret Cancer Centre (Toronto, Ontario) were surveyed between April 2014 and May 2016 for sociodemographic variables, smoking history, and perceptions of continued smoking on quality of life, survival, and fatigue. Multivariable regression models evaluated the association between patients' perceptions and smoking cessation and the factors influencing patients' perceptions of smoking. RESULTS Among 1,121 patients, 277 (23%) were smoking cigarettes up to 1 year before diagnosis, and 54% subsequently quit; 23% had lung cancer, and 27% had head and neck cancers. The majority felt that continued smoking after a cancer diagnosis negatively affected quality of life (83%), survival (86%), and fatigue (82%). Current smokers during the peridiagnosis period were less likely to perceive that continued smoking was harmful when compared with ex-smokers and never-smokers ( P < .01). Among current smokers, perceiving that smoking negatively affected quality of life (adjusted odds ratio [aOR], 2.68 [95% CI, 1.26 to 5.72]; P = .011), survival (aOR, 5.00 [95% CI, 2.19 to 11.43]; P < .001), and fatigue (aOR, 3.57 [95% CI, 1.69 to 7.54]; P < .001) were each strongly associated with smoking cessation. Among all patients, those with a greater smoking history were less likely to believe that smoking was harmful in terms of quality of life (aOR, 0.98 [95% CI, 0.98 to 0.99]; P < .001), survival (aOR, 0.98 [95% CI, 0.98 to 0.99]; P < .001), and fatigue (aOR, 0.99 [95% CI, 0.98 to 0.99]; P < .001). CONCLUSION The perceptions of continued smoking after a cancer diagnosis among patients with cancer are strongly associated with smoking cessation. Counseling about the harms of continued smoking in patients with cancer, and in particular among those who have lower risk perceptions, should be considered when developing a smoking cessation program.
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Affiliation(s)
- Devon Alton
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Lawson Eng
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Lin Lu
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Yuyao Song
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Jie Su
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Delaram Farzanfar
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Rahul Mohan
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Olivia Krys
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Katie Mattina
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Christopher Harper
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Sophia Liu
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Tom Yoannidis
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Robin Milne
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - M Catherine Brown
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Ashlee Vennettilli
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Andrew J Hope
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Doris Howell
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Jennifer M Jones
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Peter Selby
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Wei Xu
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - David P Goldstein
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Geoffrey Liu
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
| | - Meredith E Giuliani
- University of Toronto; Ontario Cancer Institute; and Princess Margaret Cancer Centre/University Health Network, Toronto, Ontario, Canada
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Decisional balance and processes of change in community-recruited with moderate-high versus mild severity of cannabis dependence. PLoS One 2017; 12:e0188476. [PMID: 29206230 PMCID: PMC5714356 DOI: 10.1371/journal.pone.0188476] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/07/2017] [Indexed: 11/19/2022] Open
Abstract
Decisional Balance and Processes of Change are generally addressed in motivational interventions for the treatment of cannabis use disorders. However, specific aspects of these multifaceted constructs, with greater relevance for severe cannabis users, need to be ascertained to enable better interventions. This study aimed to compare the different facets of decisional balance and processes of change between mild and severe cannabis users in a community-based sample of young undergraduates. Thirty-one severe cannabis users and 31 mild cannabis users, indicated with the Severity of Dependence Scale, were assessed using the Decisional Balance Questionnaire (DBQ) and the Processes of Change Questionnaire (PCQ). We found that severe cannabis users had higher scores in the DBQ dimensions of Utilitarian Gains for the Self, Utilitarian Gains for Significant Others, and Self-approval, as well as in the total subscale of Gains but not Losses. The group of severe cannabis users also had higher scores in the PCQ dimensions of Self-revaluations and Counter-conditioning. Our results pinpoint specific dimensions of Decisional Balance and Processes of Change that are endorsed by severe cannabis users. This knowledge could be applied to inform motivational interventions targeting severe cannabis users.
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Bertaglia V, Vallone S, Pacchiana MV, Novello S. Advanced squamous lung cancer: therapeutic options, future directions, unmet needs and results of a monocentric survey. Lung Cancer Manag 2017; 6:93-107. [PMID: 30643575 PMCID: PMC6310352 DOI: 10.2217/lmt-2017-0011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 10/23/2017] [Indexed: 11/21/2022] Open
Abstract
Lung cancer is the leading cause of cancer-related deaths in worldwide, and NSCLC represents around 85% of all lung cancers. Squamous cell lung cancer (SqCLC) is the second most common subtype and it is challenging to treat. New options have been discovered but progresses are still limited for the lack of 'druggable' mutations. Specific resources for SqCLC are limited and this condition affects treatment and outcomes. This paper describes available and emerging therapeutic options and resources that may help patients to face their disease. We have also performed a monocentric survey collecting information about smoking habit and sense of guilty and analyzed the possibility for patients to find helpful sources for their disease. The results suggest that more materials focused on SqCLC are still needed.
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Affiliation(s)
- Valentina Bertaglia
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | | | | | - Silvia Novello
- Department of Oncology, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
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EGFR mutation, smoking, and gender in advanced lung adenocarcinoma. Oncotarget 2017; 8:98384-98393. [PMID: 29228697 PMCID: PMC5716737 DOI: 10.18632/oncotarget.21842] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 09/24/2017] [Indexed: 01/21/2023] Open
Abstract
Purpose In the current targeted therapy era, information on the effect of smoking in epidermal growth factor receptor (EGFR)-mutant lung cancer patients is scarce. Results In total, 11,678 adenocarcinoma patients were enrolled. Of these, 33.3% and 91.8% of male and female patients were non-smokers, respectively. An increased amount of smoking (P < 0.001 for trend), fewer smoke-free years (P < 0.001 for trend), and younger age of smoking initiation (P = 0.034 for trend) were all associated with significantly lower EGFR mutation rates. Smokers had a shorter median overall survival (OS) among both EGFR-mutant and EGFR-wild type patients (17.8 vs. 21.1 months, and 7.9 vs. 11.4 months respectively; both P < 0.001). Among patients with EGFR-mutant adenocarcinoma, younger smokers were associated with shorter OS (P = 0.047). In multivariate analysis, female gender was an independent prognostic factor for OS (hazard ratio: 0.86 [95% confidence interval {CI}: 0.80-0.93]; P < 0.001 in the EGFR-mutant group and 0.88 [95% CI: 0.81-0.96]; P = 0.004 in the EGFR-wild type group). Materials and Methods We reviewed the National Lung Cancer database (Taiwan) to assess the impact of smoking on the EGFR mutation rate and survival in advanced lung adenocarcinoma patients during 2011 and 2014 retrospectively. Conclusions Smoking was associated with lower incidence of EGFR mutation rate and reduced OS of advanced lung adenocarcinoma patients in a dose-dependent manner. In addition to EGFR mutation and smoking, gender also plays an important role in survival among these patients.
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Ong J, Plueckhahn I, Cruickshank D, Churilov L, Mileshkin L. A smoking cessation programme for current and recent ex-smokers following diagnosis of a potentially curable cancer. Intern Med J 2017; 46:1089-96. [PMID: 27389637 DOI: 10.1111/imj.13172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 06/27/2016] [Accepted: 06/27/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cancer patients who quit smoking have improved survival rates. The time of diagnosis provides a 'teachable moment' when healthcare providers can offer smoking-cessation treatment. AIMS To assess the impact on quit rates of a tailored smoking-cessation intervention for patients diagnosed with a potentially curable cancer. METHODS A prospective, one-arm cohort study of current smokers and recent quitters (<30 days) who had commenced treatment for a potentially curable cancer was performed. Intervention involved an initial motivational interview, regular follow up and pharmacotherapy when appropriate. Quit rates were measured at 1, 3, 6 and 12 months by self-reported abstinence and biochemical confirmation. The primary end point was prolonged abstinence at 12 months. Changes in quality of life parameters and distress were also assessed. RESULTS Seventy-one patients were recruited, with a median age of 56 years. Forty-one patients (58%) had a smoking-related cancer. The prolonged abstinence rate at 12 months was 24% (95% confidence interval 14-36%). Factors associated with successful quitting included being in the preparation or action phase of readiness to change at study entry (P = 0.012) and having complications of treatment requiring hospitalisation (P = 0.024). Between baseline and 12 months, quitters reported improvement in self-control (P < 0.001) and reduced levels of distress (P = 0.03) compared to non-quitters. CONCLUSION Patients who continue to smoke after being diagnosed with cancer require intensive support to quit. An individualised behavioural and pharmacological intervention can be successful in helping patients quit smoking, with quality of life improvements seen amongst successful quitters. Population measures to stop people starting smoking remain essential.
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Affiliation(s)
- J Ong
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
| | - I Plueckhahn
- Department of Cancer Experiences Research,, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - D Cruickshank
- Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - L Churilov
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - L Mileshkin
- Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Cancer Experiences Research,, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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npj Primary Care Respiratory Medicine broadens its focus to include global respiratory health, tobacco control and implementation science. NPJ Prim Care Respir Med 2017. [PMID: 28642486 PMCID: PMC5481385 DOI: 10.1038/s41533-017-0044-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ganesh V, Zaki P, Chan S, Turner A, Bristow B, Di Prospero L, Gibson L, DeAngelis C, Chow E. Adverse Health Outcomes Associated with Postdiagnosis Smoking in Prostate Cancer Patients: A Literature Review. J Med Imaging Radiat Sci 2017; 48:103-110. [PMID: 31047202 DOI: 10.1016/j.jmir.2016.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Revised: 11/23/2016] [Accepted: 11/23/2016] [Indexed: 11/28/2022]
Abstract
This literature review presents what is currently known about the association between postdiagnosis smoking and adverse health outcomes in prostate cancer. A literature search was conducted using Ovid Embase and Ovid MEDLINE. Information from 36 studies was summarized. There is strong evidence across the included studies of higher overall mortality and biochemical recurrence in current smokers diagnosed with prostate cancer. In addition, enhanced adverse effects following surgery, radiation, and hormone therapy have also been identified in current smokers of this population.
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Affiliation(s)
- Vithusha Ganesh
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Pearl Zaki
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie Chan
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Angela Turner
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Bonnie Bristow
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Di Prospero
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Leslie Gibson
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Carlo DeAngelis
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - Edward Chow
- Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
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No Ifs, No Butts: Compliance with Smoking Cessation in Secondary Care Guidance (NICE PH48) by Providers of Cancer Therapies (Radiotherapy and Chemotherapy) in the UK. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13121244. [PMID: 27983709 PMCID: PMC5201385 DOI: 10.3390/ijerph13121244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 12/09/2016] [Accepted: 12/09/2016] [Indexed: 11/17/2022]
Abstract
Background: Legislation preventing smoking in public places was introduced in England in July 2007. Since then, smoke-free policies have been extended to the majority of hospitals including those providing cancer therapies. Whilst studies have been conducted on the impact and effectiveness of hospital smoke-free policy in the UK and other countries, there have not been any studies with a focus on cancer care providers. Cancer patients are a priority group for smoking cessation and support and this study aimed to examine implementation of the National Institute Clinical Excellence (NICE) guidance (PH48) in acute cancer care trusts in the UK. Methods: Participants were recruited from UK radiotherapy and chemotherapy departments (total 80 sites, 65 organisations) and asked to complete a 15 min online questionnaire exploring the implementation of NICE guidance at their hospital site. Results: Considerable variability in implementation of the NICE guidance was observed. A total of 79.1% trusts were smoke-free in theory; however, only 18.6% were described as smoke-free in practice. Areas of improvement were identified in information and support for patients and staff including in Nicotine Replacement Therapy (NRT) provision, staff training and clarity on e-cigarette policies. Conclusions: While some trusts have effective smoke-free policies and provide valuable cessation support services for patients, improvements are required to ensure that all sites fully adopt the NICE guidance.
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Mackereth P, Finchett C, Holt M. Smoke-free hospital site conversations: how nurses can initiate change. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2016; 25:1176-1180. [PMID: 27882792 DOI: 10.12968/bjon.2016.25.21.1176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Smoking tobacco continues to be the world's most preventable cause of death and disability with over six trillion cigarettes sold each year. Patients, visitors and health professionals who smoke on hospital sites present a challenge to the effectiveness of public health messages. Health professionals who ignore 'No smoking' hospital/clinic signage, and avoid smoking-cessation activity, help to sustain the perception that smoking is tolerated. Case studies, with a focus on lung cancer and chronic obstructive pulmonary disease (COPD), are used to illustrate how nurses can 'seed' the idea of hospitals becoming smoke-free, provide brief interventions and support patients, carers and colleagues to make that change.
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Affiliation(s)
- Peter Mackereth
- Tobacco Control Lead Nurse, The Christie NHS Foundation Trust, Manchester
| | | | - Melody Holt
- Community Engagement Manager, Roy Castle Lung Cancer Foundation, Liverpool
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Choi SH, Terrell JE, Bradford CR, Ghanem T, Spector ME, Wolf GT, Lipkus IM, Duffy SA. Does Quitting Smoking Make a Difference Among Newly Diagnosed Head and Neck Cancer Patients? Nicotine Tob Res 2016; 18:2216-2224. [PMID: 27613928 DOI: 10.1093/ntr/ntw189] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 07/18/2016] [Indexed: 12/18/2022]
Abstract
INTRODUCTION To determine if smoking after a cancer diagnosis makes a difference in mortality among newly diagnosed head and neck cancer patients. METHODS Longitudinal data were collected from newly diagnosed head and neck cancer patients with a median follow-up time of 1627 days (N = 590). Mortality was censored at 8 years or September 1, 2011, whichever came first. Based on smoking status, all patients were categorized into four groups: continuing smokers, quitters, former smokers, or never-smokers. A broad range of covariates were included in the analyses. Kaplan-Meier curves, bivariate and multivariate Cox proportional hazards models were constructed. RESULTS Eight-year overall mortality and cancer-specific mortality were 40.5% (239/590) and 25.4% (150/590), respectively. Smoking status after a cancer diagnosis predicted overall mortality and cancer-specific mortality. Compared to never-smokers, continuing smokers had the highest hazard ratio (HR) of dying from all causes (HR = 2.71, 95% confidence interval [CI] = 1.48-4.98). Those who smoked at diagnosis, but quit and did not relapse-quitters-had an improved hazard ratio of dying (HR = 2.38, 95% CI = 1.29-4.36) and former smokers at diagnosis with no relapse after diagnosis-former smokers-had the lowest hazard ratio of dying from all causes (HR = 1.68, 95% CI = 1.12-2.56). Similarly, quitters had a slightly higher hazard ratio of dying from cancer-specific reasons (HR = 2.38, 95% CI = 1.13-5.01) than never-smokers, which was similar to current smokers (HR = 2.07, 95% CI = 0.96-4.47), followed by former smokers (HR = 1.70, 95% CI = 1.00-2.89). CONCLUSIONS Compared to never-smokers, continuing smokers have the highest HR of overall mortality followed by quitters and former smokers, which indicates that smoking cessation, even after a cancer diagnosis, may improve overall mortality among newly diagnosed head and neck cancer patients. Health care providers should consider incorporating smoking cessation interventions into standard cancer treatment to improve survival among this population. IMPLICATIONS Using prospective observational longitudinal data from 590 head and neck cancer patients, this study showed that continuing smokers have the highest overall mortality relative to never-smokers, which indicates that smoking cessation, even after a cancer diagnosis, may have beneficial effects on long-term overall mortality. Health care providers should consider incorporating smoking cessation interventions into standard cancer treatment to improve survival among this population.
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Affiliation(s)
- Seung Hee Choi
- College of Nursing, Michigan State University, East Lansing, MI
| | | | | | | | | | | | | | - Sonia A Duffy
- College of Nursing, Ohio State University, Columbus, OH; .,Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI
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Lucchiari C, Masiero M, Botturi A, Pravettoni G. Helping patients to reduce tobacco consumption in oncology: a narrative review. SPRINGERPLUS 2016; 5:1136. [PMID: 27504234 PMCID: PMC4954805 DOI: 10.1186/s40064-016-2798-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 07/08/2016] [Indexed: 11/10/2022]
Abstract
The present overview focuses on evidence of smoking cessation approaches in oncology settings with the aim to provide health personnel a critical perspective on how to help their patients. This narrative review is structured in two main sections: the first one describes the psycho-cognitive variables involved in the decision to continue smoking after a cancer diagnosis and during the treatment; the second section relates methods and tools may be recommended, being evidence-based, to support smoking cessation in oncology settings. Active smoking increases not only susceptibility to common cancers in the general population, but also increases disease severity and comorbidities in cancer patients. Nowadays, scientific evidence has identified many strategies to give up smoking, but a lack of knowledge exists for treatment of nicotine dependence in the cancer population. Health personnel is often ambiguous when approaching the problem, while their contribution is essential in guiding patients towards healthier choices. We argue that smoking treatments for cancer patients deserve more attention and that clinical features, individual characteristics and needs of the patient should be assessed in order to increase the attempts success rate. Health personnel that daily work and interact with cancer patients and their caregivers have a fundamental role in the promotion of the health changing. For this reason, it is important that they have adequate knowledge and resources in order to support cancer patients to stop tobacco cigarette smoking and promoting and healthier lifestyle.
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Affiliation(s)
- Claudio Lucchiari
- />Department of Philosophy, Università degli Studi di Milano, Milan, Italy
| | - Marianna Masiero
- />Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- />Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
| | - Andrea Botturi
- />Department of Neurooncology, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy
| | - Gabriella Pravettoni
- />Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
- />Applied Research Unit for Cognitive and Psychological Science, European Institute of Oncology, Milan, Italy
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Peddireddy V. Psychological interventions to improve the quality of life in Indian lung cancer patients: A neglected area. J Health Psychol 2016; 24:100-112. [PMID: 27287601 DOI: 10.1177/1359105316650930] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The incidence of lung cancer is very high and evidence suggests that patients experience imbalanced emotional capabilities due to less survival rate compared to other cancers. Direct and indirect psychological interventions are mandatory to improve the outcome of lung cancer treatment. Although such interventions are being practiced in developed nations, the effects of psychological interventions on the treatment outcome in the Indian context are lacking. Since there is a definite correlation between treatment outcome and psychological issues, it is high time that clinicians in developing countries including India adopt practices to enhance the quality of life of lung cancer patients.
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Costa G, Thuler LCS, Ferreira CG. Epidemiological changes in the histological subtypes of 35,018 non-small-cell lung cancer cases in Brazil. Lung Cancer 2016; 97:66-72. [PMID: 27237030 DOI: 10.1016/j.lungcan.2016.04.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 04/19/2016] [Accepted: 04/26/2016] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Regarding the fatality rates stemming from various existing forms of cancers worldwide, lung cancer (LC) is ranked as the main cause of death amongst those who suffer from cancer. Although the epidemiological, clinical, and histological profile of patients with this type of cancer is largely unknown, Brazil has made tremendous efforts to generate data for supporting healthcare policies concerning lung cancer. Taking these factors into account, this study aims to analyse the epidemiological, clinical, and histological profiles of patients with non-small-cell lung cancer (NSCLC) in Brazil. MATERIAL AND METHODS For this study, a cross-sectional epidemiological study was conducted to nationally analyse patient's data within the cancer hospital registries found in the National Cancer Institute (INCA) and the São Paulo Cancer Foundation (FOSP) between 2000 and 2011. RESULTS A total of 35,018 patients diagnosed with NSCLC in Brazil between 2000 and 2011 were analysed. The analysis demonstrated the occurrence of an epidemiological shift, related to the most prevalent histological type of NSCLC in the study population from 2003. The shift resulted in a higher percentage of adenocarcinoma (43.3%) over squamous cell carcinoma (36.5%). Additionally, there was a significant increase in both the number of cases of LC in women and in the rates of patients diagnosed with metastatic disease. CONCLUSION The use of filtered cigarettes since the 60's and the increase in the number of LC cases in women, were one of the causes for the switch in the histological profile of NSCLC in Brazil. Consequently, adenocarcinoma is now the predominant type of cancer detected. Late diagnosis is a hallmark sign.
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Affiliation(s)
- Guilherme Costa
- Department of Oncology, Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Pernambuco, Brazil
| | | | - Carlos Gil Ferreira
- Clinical Research Division, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil; National Clinical Cancer Research Network (RNPCC), Brazilian Ministry of Health, Brazil
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Land SR, Toll BA, Moinpour CM, Mitchell SA, Ostroff JS, Hatsukami DK, Duffy SA, Gritz ER, Rigotti NA, Brandon TH, Prindiville SA, Sarna LP, Schnoll RA, Herbst RS, Cinciripini PM, Leischow SJ, Dresler CM, Fiore MC, Warren GW. Research Priorities, Measures, and Recommendations for Assessment of Tobacco Use in Clinical Cancer Research. Clin Cancer Res 2016; 22:1907-13. [PMID: 26888828 PMCID: PMC4861174 DOI: 10.1158/1078-0432.ccr-16-0104] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 01/28/2016] [Indexed: 01/12/2023]
Abstract
There is strong evidence that cigarette smoking causes adverse outcomes in people with cancer. However, more research is needed regarding those effects and the effects of alternative tobacco products and of secondhand smoke, the effects of cessation (before diagnosis, during treatment, or during survivorship), the biologic mechanisms, and optimal strategies for tobacco dependence treatment in oncology. Fundamentally, tobacco is an important source of variation in clinical treatment trials. Nevertheless, tobacco use assessment has not been uniform in clinical trials. Progress has been impeded by a lack of consensus regarding tobacco use assessment suitable for cancer patients. The NCI-AACR Cancer Patient Tobacco Use Assessment Task Force identified priority research areas and developed recommendations for assessment items and timing of assessment in cancer research. A cognitive interview study was conducted with 30 cancer patients at the NIH Clinical Center to evaluate and improve the measurement items. The resulting Cancer Patient Tobacco Use Questionnaire (C-TUQ) includes "Core" items for minimal assessment of tobacco use at initial and follow-up time points, and an "Extension" set. Domains include the following: cigarette and other tobacco use status, intensity, and past use; use relative to cancer diagnosis and treatment; cessation approaches and history; and secondhand smoke exposure. The Task Force recommends that assessment occur at study entry and, at a minimum, at the end of protocol therapy in clinical trials. Broad adoption of the recommended measures and timing protocol, and pursuit of the recommended research priorities, will help us to achieve a clearer understanding of the significance of tobacco use and cessation for cancer patients.
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Affiliation(s)
- Stephanie R Land
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland.
| | - Benjamin A Toll
- Hollings Cancer Center, Medical University of South Carolina (MUSC), Charleston, South Carolina
| | - Carol M Moinpour
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Sandra A Mitchell
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland
| | | | - Dorothy K Hatsukami
- Masonic Cancer Center, University of Minnesota (DKH), Minneapolis, Minnesota
| | - Sonia A Duffy
- College of Nursing and VA Center for Clinical Management Research, HSR&D Center of Excellence, The Ohio State University, Columbus, Ohio
| | - Ellen R Gritz
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Nancy A Rigotti
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Thomas H Brandon
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, Florida
| | - Sheila A Prindiville
- Coordinating Center for Clinical Trials, National Cancer Institute, Bethesda, Maryland
| | - Linda P Sarna
- School of Nursing, University of California, Los Angeles, California
| | | | - Roy S Herbst
- Yale School of Medicine, Yale Cancer Center, New Haven, Connecticut
| | - Paul M Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Scott J Leischow
- College of Medicine, Mayo Clinic Cancer Center, Mayo Clinic Phoenix, Phoenix, Arizona
| | | | - Michael C Fiore
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Graham W Warren
- Hollings Cancer Center, Medical University of South Carolina (MUSC), Charleston, South Carolina. Department of Radiation Oncology, Medical University of South Carolina (MUSC), Charleston, South Carolina. Department of Cell and Molecular Pharmacology, Medical University of South Carolina (MUSC), Charleston, South Carolina
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81
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Rivera C, Rivera S, Fabre E, Pricopi C, Le Pimpec-Barthes F, Riquet M. [Consequences of tobacco smoking on lung cancer treatments]. REVUE DE PNEUMOLOGIE CLINIQUE 2016; 72:136-141. [PMID: 25727658 DOI: 10.1016/j.pneumo.2014.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 11/10/2014] [Accepted: 11/18/2014] [Indexed: 06/04/2023]
Abstract
In France, in 2010, tobacco induced 81% of deaths by lung cancer corresponding to about 28,000 deaths. Continued smoking after diagnosis has a significant impact on treatment. In patients with lung cancer, the benefits of smoking cessation are present at any stage of disease. For early stages, smoking cessation decreases postoperative morbidity, reduces the risk of second cancer and improves survival. Previous to surgery, smoking cessation of at least six to eight weeks or as soon as possible is recommended in order to reduce the risk of infectious complications. Tobacco could alter the metabolism of certain chemotherapies and targeted therapies, such as tyrosine kinase inhibitors of the EGF receptor, through an interaction with P450 cytochrome. Toxicity of radiations could be lower in patients with lung cancer who did not quit smoking before treatment. For patients treated by radio-chemotherapy, overall survival seems to be better in former smokers but no difference is observed in terms of recurrence-free survival. For advanced stages, smoking cessation enhances patients' quality of life. Smoking cessation should be considered as full part of lung cancer treatment whatever the stage of disease.
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Affiliation(s)
- C Rivera
- Service de chirurgie thoracique et transplantation pulmonaire, université Paris Descartes, hôpital européen Georges-Pompidou, 20-40, rue Leblanc, 75015 Paris, France
| | - S Rivera
- Service de radiothérapie, institut Gustave-Roussy, 94800 Villejuif, France
| | - E Fabre
- Service d'oncologie médicale, université Paris-Descartes, hôpital européen Georges-Pompidou, 75015 Paris, France
| | - C Pricopi
- Service de chirurgie thoracique et transplantation pulmonaire, université Paris Descartes, hôpital européen Georges-Pompidou, 20-40, rue Leblanc, 75015 Paris, France
| | - F Le Pimpec-Barthes
- Service de chirurgie thoracique et transplantation pulmonaire, université Paris Descartes, hôpital européen Georges-Pompidou, 20-40, rue Leblanc, 75015 Paris, France
| | - M Riquet
- Service de chirurgie thoracique et transplantation pulmonaire, université Paris Descartes, hôpital européen Georges-Pompidou, 20-40, rue Leblanc, 75015 Paris, France.
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82
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Chang YY, Yu SM, Lai YJ, Wu PL, Huang KC, Huang HL. Improving smoking cessation outcomes in secondary care: Predictors of hospital staff willingness to provide smoking cessation referral. Prev Med Rep 2016; 3:229-33. [PMID: 27419019 PMCID: PMC4929235 DOI: 10.1016/j.pmedr.2016.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 02/01/2016] [Accepted: 02/29/2016] [Indexed: 01/06/2023] Open
Abstract
Since implementation of the New Smoking Cessation Policy in Taiwan, more patients are attending smoking cessation clinics. Many of these patients were referred by hospital staff. Thus, factors which influence the hospital staff's willingness to refer are important. In this study, we aim to understand the relation between smoking cessation knowledge and willingness for referral. A cross-sectional study using a questionnaire was conducted with staff of a community hospital during the year 2012–2013. Willingness to provide smoking cessation referral and relevant correlated variables including demographic data, knowledge of basic cigarette harm, and knowledge of resources and methods regarding smoking cessation were measured. A total of 848 of 1500 hospital staff returned the questionnaire: 249 physicians (29.4%), 402 nursing staff (47.4%), and 197 administration staff (23.2%). 790 (93.2%) staff members have never smoked, 19 (2.2%) had quit smoking, and 39 (4.6%) still smoke. 792 (93.4%) members had interest in receiving smoking cessation education. The mean total score (highest potential score of 6) of basic cigarette harm knowledge was 4.56 (± 1.25). The mean total score (highest potential score of 7) of resources and methods about smoking cessation was 4.79 (± 1.35). The significant variable correlated with willingness to refer was total score of resources and methods about smoking cessation. Hospital staff who knew more about resources and methods about smoking cessation were more willing to refer smoking patients to the smoking cessation service. Thus, continuing medical education for hospital staff should include resources and methods about smoking cessation to promote smoking cessation. Knowledge of methods and resources for smoking cessation increases referral rates. Just educating about smoking harm will not increase willingness for referral. Education should include resources and methods about smoking cessation.
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Affiliation(s)
- Yin-Yu Chang
- Department of Family Medicine, Taiwan Adventist Hospital, 424 Sec. 2 Bade Road, Songshan District, Taipei City 105, Taiwan
| | - Shu-Man Yu
- Department of Family Medicine, Cardinal Tien Hospital, 362 Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan
| | - Yun-Ju Lai
- Department of Family Medicine, Cardinal Tien Hospital, 362 Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan
| | - Ping-Lun Wu
- Department of Family Medicine, Cardinal Tien Hospital, 362 Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan; Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, 1 Changde Street, Zhongzheng District, Taipei City 100, Taiwan
| | - Kuo-Chin Huang
- Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, 1 Changde Street, Zhongzheng District, Taipei City 100, Taiwan; Graduate Institute of Clinical Medical Science, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan
| | - Hsien-Liang Huang
- Department of Family Medicine, Cardinal Tien Hospital, 362 Zhongzheng Road, Xindian District, New Taipei City 231, Taiwan; Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, 1 Changde Street, Zhongzheng District, Taipei City 100, Taiwan; School of Medicine, Fu-Jen Catholic University, 510 Zhongzheng Road, Xinzhuang District, New Taipei City 242, Taiwan
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83
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Zeng L, Yu X, Yu T, Xiao J, Huang Y. Interventions for smoking cessation in people diagnosed with lung cancer. Cochrane Database Syst Rev 2015:CD011751. [PMID: 26632766 DOI: 10.1002/14651858.cd011751.pub2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Lung cancer is one of the most common causes of death from cancer worldwide. Smoking induces and aggravates many health problems, including vascular diseases, respiratory illnesses and cancers. Tobacco smoking constitutes the most important risk factor for lung cancer. Most people with lung cancer are still active smokers at diagnosis or frequently relapse after smoking cessation. Quitting smoking is the most effective way for smokers to reduce the risk of premature death and disability. People with lung cancer may benefit from stopping smoking. Whether smoking cessation interventions are effective for people with lung cancer and whether one method of quitting is more effective than any other has not been systematically reviewed. OBJECTIVES To determine the effectiveness of smoking cessation programmes for people with lung cancer. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (accessed via PubMed) and EMBASE up to 22 June 2015. We also searched the American Society of Clinical Oncology (ASCO) Annual Meeting proceedings, the lung cancer sections of the proceedings of the ESMO Congress, the lung cancer sections of the proceedings of the European Conference of Clinical Oncology (ECCO) Congress, the World Conference on Lung Cancer proceedings, the Society for Research on Nicotine and Tobacco Annual Meeting from 2013, the Food and Drug Administration website, the European Medicine Agency for drug registration website, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal, ClinicalTrials.gov, and the metaRegister of Controlled Trials (mRCT) to 1 July 2015. We applied no restriction on language of publication. SELECTION CRITERIA We planned to include any randomised controlled trial (RCT) of any psychosocial or pharmacological smoking cessation intervention or combinations of both, compared with no intervention, a different psychosocial or pharmacological (or both) intervention or placebo for pharmacological interventions in people with lung cancer. DATA COLLECTION AND ANALYSIS Two review authors independently screened the studies from the initial search for potential trials for inclusion. We planned to use standard methodological procedures expected by Cochrane. We found no trials that met the inclusion criteria. MAIN RESULTS We identified no RCTs that met our inclusion criteria. Among the 1052 records retrieved using our search strategy, we retrieved 13 studies for further investigation. We excluded 10 trials: five trials because we could not distinguish people with lung cancer from the other participants, or the participants were not people with lung cancer, four because they were not randomised, or RCTs. We excluded one trial because, though it was completed in 2004, no results are available. We assessed three ongoing trials for inclusion when data become available. AUTHORS' CONCLUSIONS There were no RCTs that determined the effectiveness of any type of smoking cessation programme for people with lung cancer. There was insufficient evidence to determine whether smoking cessation interventions are effective for people with lung cancer and whether one programme is more effective than any other. People with lung cancer should be encouraged to quit smoking and offered smoking cessation interventions. However, due to the lack of RCTs, the efficacy of smoking cessation interventions for people with lung cancer cannot be evaluated and concluded. This systematic review identified a need for RCTs to explore these.
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Affiliation(s)
- Linmiao Zeng
- Department of Respiratory Medicine, Mindong Hospital Affiliated to Fujian Medical University, No. 89, He'shan Road, Fu'an City, Fujian Province, China, 355000
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84
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Affiliation(s)
- Peter Mackereth
- Tobacco Control Lead The Christie NHS Foundation Trust Manchester
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85
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Liu M, Zhou C, Zheng J. Cigarette smoking impairs the response of EGFR-TKIs therapy in lung adenocarcinoma patients by promoting EGFR signaling and epithelial-mesenchymal transition. Am J Transl Res 2015; 7:2026-2035. [PMID: 26692946 PMCID: PMC4656779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 08/17/2015] [Indexed: 06/05/2023]
Abstract
Cigarette smoking represents for the highest risk-factor for non-small cell lung cancer (NSCLC), and a growing body of evidence suggested that smoking was associated with a high recurrence and poor therapeutic response of NSCLC as well. On the other hand, epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs), such as gefitinib, has been proved to be an efficient and safe strategy for treating NSCLC. Although accumulating clinical data suggested that smoking history might influence the therapeutic effects of EGFR-TKIs even in NSCLC patients harboring sensitive EGFR mutation, the exact effects of cigarette smoking on the efficacy of EGFR-TKIs treatment in NSCLC patients remain exclusive. In this study, we firstly identified the adverse effect of smoking exposure on the efficacy of EGFR-TKIs treatment against lung adenocarcinoma in mutation-positive patients by retrospective analysis of clinical data. The hypo-responsiveness of smoking patients on the therapy was accompanied with persistent activation of EGFR-downstream signal molecules ERK1/2 and AKT, which could not be inhibited by gefitinib and thus lead to the failure of EGFR-TKIs treatment. Based on our in vitro data, it was also found that long-term cigarette smoking extract (CSE) exposure induced epithelial-mesenchymal transition (EMT), which might also contribute to acquired resistance to EGFR-TKIs. Taken together, our findings suggested that cigarette smoking negatively regulated the clinical outcome of EGFR-TKIs therapy in lung adenocarcinoma patients, which was correlated with the activation of EGFR signaling and the induction of EMT.
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Affiliation(s)
- Ming Liu
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510120, China
| | - Chenzhi Zhou
- State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510120, China
| | - Jian Zheng
- Department of Paediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong KongHong Kong SAR 000000, China
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86
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Igawa S, Sasaki J, Otani S, Ishihara M, Takakura A, Katagiri M, Masuda N. Impact of Smoking History on the Efficacy of Gefitinib in Patients with Non-Small Cell Lung Cancer Harboring Activating Epidermal Growth Factor Receptor Mutations. Oncology 2015; 89:275-80. [PMID: 26335629 DOI: 10.1159/000438703] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 07/10/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Gefitinib treatment has come to be recognized as the standard therapy for patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations. However, resistance to gefitinib has been observed in certain subpopulations of these patients. The purpose of this study was to evaluate the impact of smoking status on the efficacy of gefitinib in patients with NSCLC harboring EGFR mutations. METHODS The records of NSCLC patients harboring EGFR mutations who were treated with gefitinib at Kitasato University Hospital were retrospectively reviewed, and the treatment outcomes were evaluated. RESULTS In 153 patients with NSCLC harboring EGFR mutations, the overall response rate and progression-free survival (PFS) were 66.7% and 9.0 months, respectively. PFS differed significantly among the current smokers and never-smokers/former light smokers (10.7 vs. 5.4 months, p=0.0002), and the response rate was significantly higher in the never-smokers/former light smokers than in the current smokers (72.3 vs. 55.8%, p=0.04). Multivariate analysis identified smoking status as an independent predictor of PFS. CONCLUSION The clinical data obtained in this study provide a valuable rationale for considering smoking status as a predictor of the efficacy of gefitinib in patients with NSCLC harboring activating EGFR mutations.
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Affiliation(s)
- Satoshi Igawa
- Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan
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87
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Knobf M, Cooley M, Duffy S, Doorenbos A, Eaton L, Given B, Mayer D, McCorkle R, Miaskowski C, Mitchell S, Sherwood P, Bender C, Cataldo J, Hershey D, Katapodi M, Menon U, Schumacher K, Sun V, Ah D, LoBiondo-Wood G, Mallory G. The 2014–2018 Oncology Nursing Society Research Agenda. Oncol Nurs Forum 2015; 42:450-65. [DOI: 10.1188/15.onf.450-465] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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88
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Underner M, Perriot J, Merson F, Peiffer G, Meurice JC. [Influence of tobacco smoking on quality of life in patients with lung cancer]. Rev Mal Respir 2015; 32:586-98. [PMID: 26231411 DOI: 10.1016/j.rmr.2014.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 08/11/2014] [Indexed: 02/08/2023]
Abstract
Tobacco smoking is the leading cause of lung cancer. This cancer is the most specific indicator of the effects of tobacco on health. Regardless of the type of lung cancer and the stage of the disease, continued smoking has a negative impact on its development and its treatment. For this reason, smoking cessation is an essential step in the management of patients with lung cancer who smoke. It has been clearly demonstrated that quality of life is worse in smokers than in non-smokers. The aim of this general review is to study the relationship between tobacco use and quality of life specifically in patients with lung cancer. Among the twelve studies selected, six of them clearly demonstrate a deleterious effect of continued smoking tobacco or a beneficial effect of smoking cessation on the quality of life in patients with lung cancer. These findings should lead clinicians to offer support to smokers with lung cancer in order to assist them to quit smoking.
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Affiliation(s)
- M Underner
- Service de pneumologie, unité de tabacologie, CHU La Milétrie, BP 577, pavillon René-Beauchant, 86021 Poitiers cedex, France.
| | - J Perriot
- Dispensaire Emile-Roux, CLAT 63, centre de tabacologie, 63000 Clermont-Ferrand, France
| | - F Merson
- Dispensaire Emile-Roux, CLAT 63, centre de tabacologie, 63000 Clermont-Ferrand, France
| | - G Peiffer
- Service de pneumologie, unité de tabacologie, CHR Metz-Thionville, 57038 Metz, France
| | - J-C Meurice
- Service de pneumologie, unité de tabacologie, CHU La Milétrie, BP 577, pavillon René-Beauchant, 86021 Poitiers cedex, France
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89
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Zeng L, Yu X, Yu T, Xiao J, Huang Y. Interventions for smoking cessation in people diagnosed with lung cancer. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2015. [DOI: 10.1002/14651858.cd011751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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90
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Eng L, Qiu X, Su J, Pringle D, Niu C, Mahler M, Charow R, Villeneuve J, Halytskyy O, Lam C, Tiessen K, Brown MC, Howell D, Giuliani ME, Jones JM, Alibhai SMH, Goldstein DP, Xu W, Selby P, Liu G. The role of second-hand smoke exposure on smoking cessation in non-tobacco-related cancers. Cancer 2015; 121:2655-63. [DOI: 10.1002/cncr.29340] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/07/2015] [Accepted: 02/10/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Lawson Eng
- Division of Medical Oncology and Hematology; Department of Medicine; Princess Margaret Cancer Centre/University Health Network and University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Toronto Ontario Canada
- Department of Medicine; University Health Network; Toronto Ontario Canada
| | - Xin Qiu
- Department of Biostatistics; Princess Margaret Cancer Centre/University Health Network and University of Toronto; Toronto Ontario Canada
| | - Jie Su
- Department of Biostatistics; Princess Margaret Cancer Centre/University Health Network and University of Toronto; Toronto Ontario Canada
| | - Dan Pringle
- Ontario Cancer Institute; Toronto Ontario Canada
| | - Chongya Niu
- Division of Medical Oncology and Hematology; Department of Medicine; Princess Margaret Cancer Centre/University Health Network and University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Toronto Ontario Canada
| | - Mary Mahler
- Ontario Cancer Institute; Toronto Ontario Canada
| | | | | | | | | | | | | | - Doris Howell
- Division of Medical Oncology and Hematology; Department of Medicine; Princess Margaret Cancer Centre/University Health Network and University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Toronto Ontario Canada
| | - Meredith E. Giuliani
- Ontario Cancer Institute; Toronto Ontario Canada
- Department of Radiation Oncology; Princess Margaret Cancer Centre; Toronto Ontario Canada
| | | | | | - David P. Goldstein
- Department of Otolaryngology-Head and Neck Surgery; University of Toronto, University Health Network; Toronto Ontario Canada
| | - Wei Xu
- Department of Biostatistics; Princess Margaret Cancer Centre/University Health Network and University of Toronto; Toronto Ontario Canada
- Dalla Lana School of Public Health, University of Toronto; Toronto Ontario Canada
| | - Peter Selby
- Centre for Addiction and Mental Health; University of Toronto; Toronto Ontario Canada
- Department of Family and Community Medicine; University of Toronto; Toronto Ontario Canada
- Department of Psychiatry; University of Toronto; Toronto Ontario Canada
| | - Geoffrey Liu
- Division of Medical Oncology and Hematology; Department of Medicine; Princess Margaret Cancer Centre/University Health Network and University of Toronto; Toronto Ontario Canada
- Ontario Cancer Institute; Toronto Ontario Canada
- Department of Medicine; University Health Network; Toronto Ontario Canada
- Dalla Lana School of Public Health, University of Toronto; Toronto Ontario Canada
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91
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Siegel RD, Castro KM, Eisenstein J, Stallings H, Hegedus PD, Bryant DM, Kadlubek PJ, Clauser SB. Quality improvement in the national cancer institute community cancer centers program: the quality oncology practice initiative experience. J Oncol Pract 2015; 11:e247-54. [PMID: 25538082 PMCID: PMC4371125 DOI: 10.1200/jop.2014.000703] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) began in 2007; it is a network of community-based hospitals funded by the NCI. Quality of care is an NCCCP priority, with participation in the American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) playing a fundamental role in quality assessment and quality improvement (QI) projects. Using QOPI methodology, performance on quality measures was analyzed two times per year over a 3-year period to enhance our implementation of quality standards at NCCCP hospitals. METHODS A data-sharing agreement allowed individual-practice QOPI data to be electronically sent to the NCI. Aggregated data with the other NCCCP QOPI participants were presented to the network via Webinars. The NCCCP Quality of Care Subcommittee selected areas in which to focus subsequent QI efforts, and high-performing practices shared voluntarily their QI best practices with the network. RESULTS QOPI results were compiled semiannually between fall 2010 and fall 2013. The network concentrated on measures with a quality score of ≤ 0.75 and planned voluntary group-wide QI interventions. We identified 13 measures in which the NCCCP fell at or below the designated quality score in fall 2010. After implementing a variety of QI initiatives, the network registered improvements in all parameters except one (use of treatment summaries). CONCLUSION Using the NCCCP as a paradigm, QOPI metrics provide a useful platform for group-wide measurement of quality performance. In addition, these measurements can be used to assess the effectiveness of QI initiatives.
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Affiliation(s)
- Robert D Siegel
- Hartford Hospital-Helen and Harry Gray Cancer Center, Hartford, CT; National Cancer Institute, Bethesda, MD; Norton Cancer Institute, Louisville, KY; Gibbs Cancer Center-Spartanburg Healthcare System, Spartanburg, SC; Mary Bird Perkins-Our Lady of the Lake Cancer Center, Baton Rouge, LA; and American Society of Clinical Oncology, Alexandria, VA
| | - Kathleen M Castro
- Hartford Hospital-Helen and Harry Gray Cancer Center, Hartford, CT; National Cancer Institute, Bethesda, MD; Norton Cancer Institute, Louisville, KY; Gibbs Cancer Center-Spartanburg Healthcare System, Spartanburg, SC; Mary Bird Perkins-Our Lady of the Lake Cancer Center, Baton Rouge, LA; and American Society of Clinical Oncology, Alexandria, VA
| | - Jana Eisenstein
- Hartford Hospital-Helen and Harry Gray Cancer Center, Hartford, CT; National Cancer Institute, Bethesda, MD; Norton Cancer Institute, Louisville, KY; Gibbs Cancer Center-Spartanburg Healthcare System, Spartanburg, SC; Mary Bird Perkins-Our Lady of the Lake Cancer Center, Baton Rouge, LA; and American Society of Clinical Oncology, Alexandria, VA
| | - Holley Stallings
- Hartford Hospital-Helen and Harry Gray Cancer Center, Hartford, CT; National Cancer Institute, Bethesda, MD; Norton Cancer Institute, Louisville, KY; Gibbs Cancer Center-Spartanburg Healthcare System, Spartanburg, SC; Mary Bird Perkins-Our Lady of the Lake Cancer Center, Baton Rouge, LA; and American Society of Clinical Oncology, Alexandria, VA
| | - Patricia D Hegedus
- Hartford Hospital-Helen and Harry Gray Cancer Center, Hartford, CT; National Cancer Institute, Bethesda, MD; Norton Cancer Institute, Louisville, KY; Gibbs Cancer Center-Spartanburg Healthcare System, Spartanburg, SC; Mary Bird Perkins-Our Lady of the Lake Cancer Center, Baton Rouge, LA; and American Society of Clinical Oncology, Alexandria, VA
| | - Donna M Bryant
- Hartford Hospital-Helen and Harry Gray Cancer Center, Hartford, CT; National Cancer Institute, Bethesda, MD; Norton Cancer Institute, Louisville, KY; Gibbs Cancer Center-Spartanburg Healthcare System, Spartanburg, SC; Mary Bird Perkins-Our Lady of the Lake Cancer Center, Baton Rouge, LA; and American Society of Clinical Oncology, Alexandria, VA
| | - Pam J Kadlubek
- Hartford Hospital-Helen and Harry Gray Cancer Center, Hartford, CT; National Cancer Institute, Bethesda, MD; Norton Cancer Institute, Louisville, KY; Gibbs Cancer Center-Spartanburg Healthcare System, Spartanburg, SC; Mary Bird Perkins-Our Lady of the Lake Cancer Center, Baton Rouge, LA; and American Society of Clinical Oncology, Alexandria, VA
| | - Steven B Clauser
- Hartford Hospital-Helen and Harry Gray Cancer Center, Hartford, CT; National Cancer Institute, Bethesda, MD; Norton Cancer Institute, Louisville, KY; Gibbs Cancer Center-Spartanburg Healthcare System, Spartanburg, SC; Mary Bird Perkins-Our Lady of the Lake Cancer Center, Baton Rouge, LA; and American Society of Clinical Oncology, Alexandria, VA
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Effects of cigarette smoking on metabolism and effectiveness of systemic therapy for lung cancer. J Thorac Oncol 2015; 9:917-926. [PMID: 24926542 DOI: 10.1097/jto.0000000000000191] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Cigarette smoke associated polycyclic aromatic hydrocarbons can induce key drug-metabolizing enzymes of cytochrome P450 and isoforms of the glucuronyl transferases families. These enzymes metabolize several systemic therapies for lung cancer. Induction of these enzymes may lead to accelerated clearance with resultant impact on systemic therapy efficacy and toxicity in smokers compared with nonsmokers. This article reviews published literature regarding the influence of smoking as it relates to alteration of metabolism of systemic therapy in lung cancer. METHODS A structured search of the National Library of Medicine's PubMed/MEDLINE identified relevant articles. Data were abstracted and analyzed to summarize the findings. RESULTS Studies that analyzed pharmacokinetic data were prospective. Smokers receiving erlotinib exhibited rapid clearance, requiring a higher dose to reach equivalent systemic exposure compared with nonsmokers. Smokers receiving irinotecan also demonstrated increased clearance and lower systemic exposure. There was no difference in clearance of paclitaxel or docetaxel in smokers. Chemotherapy-associated neutropenia was worse in nonsmokers compared with smokers in patients treated with paclitaxel, docetaxel, irinotecan, and gemcitabine. CONCLUSIONS Systemic therapy for lung cancer has a narrow therapeutic index such that small changes in plasma concentrations or exposure in smokers may result in suboptimal therapy and poor outcomes. Smoking cessation must be emphasized at each clinical visit. However, prospective trials should take into consideration the effects of smoking history on drug pharmacokinetics and efficacy. The metabolizing enzyme phenotype in smokers may require individualized dose algorithms for specific agents.
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Li H, Wang S, Takayama K, Harada T, Okamoto I, Iwama E, Fujii A, Ota K, Hidaka N, Kawano Y, Nakanishi Y. Nicotine induces resistance to erlotinib via cross-talk between α 1 nAChR and EGFR in the non-small cell lung cancer xenograft model. Lung Cancer 2015; 88:1-8. [PMID: 25670150 DOI: 10.1016/j.lungcan.2015.01.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Revised: 12/26/2014] [Accepted: 01/20/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Given our previously published study, α 1 nicotinic acetylcholine receptor (nAChR) plays an essential role in nicotine-induced cell signaling and nicotine-induced resistance to epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) in non-small cell lung cancer (NSCLC) PC9 cells. The aim of this study was to investigate the potential mechanism between nAChR and EGFR for nicotine-induced resistance to EGFR-TKI erlotinib in the NSCLC xenograft model. MATERIALS AND METHODS We identified the role of nicotine to EGFR/AKT/ERK pathways and to erlotinib-resistance in NSCLC PC9 and HCC827 cells by MTS assay and western blot. Then, we established the PC9 xenograft model with nicotine exposure and treated mice with erlotinib combined with vehicle or nicotine. RESULTS We confirmed the effects of nicotine on EGFR/AKT/ERK pathways and determined nicotine's potential in preventing from the effect of erlotinib on NSCLC cells. Then, we showed that nicotine exposures can promote tumor growth and induce resistance to erlotinib in the PC9 xenograft model. Our results also indicated that chronic oral administration of nicotine can cause more significant erlotinib-resistance compared with acute i.v. injection of nicotine through activating α 1 nAChR and EGFR pathways. CONCLUSIONS These results suggest that nicotine contributes to the progression and erlotinib-resistance of the NSCLC xenograft model via the cooperation between nAChR and EGFR.
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Affiliation(s)
- Heyan Li
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shuo Wang
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan; Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Koichi Takayama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Taishi Harada
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Isamu Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Iwama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akiko Fujii
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keiichi Ota
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noriko Hidaka
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuko Kawano
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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94
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Silver JK. Cancer prehabilitation and its role in improving health outcomes and reducing health care costs. Semin Oncol Nurs 2014; 31:13-30. [PMID: 25636392 DOI: 10.1016/j.soncn.2014.11.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine the current state of cancer prehabilitation care and the impact that it may have on health-related and financial outcomes. DATA SOURCES Clinical trials, reviews and meta-analyses. CONCLUSION Research demonstrates that prehabilitation interventions may improve physical and/or psychological outcomes and help patients function at a higher level throughout their cancer treatment. Establishing a baseline status at diagnosis provides an opportunity to gain insight into the burden that cancer and its treatment can place on survivors with respect to physical and psychological impairments, function, and disability. Targeted interventions may reduce the incidence and/or severity of future impairments that often lead to reduced surgical complications, hospital lengths of stay, hospital readmissions, and overall health care costs. Thus, cancer prehabilitation is an opportunity to positively impact patient health-related and financial outcomes from diagnosis onward and, by decreasing the financial impact that cancer can have on individuals, may prove to be a sound investment for patients, hospitals, payers and society. IMPLICATIONS FOR NURSING PRACTICE Nurses, and particularly navigators, have an opportunity to significantly impact care through patient screening, prehabilitation assessments, documentation of baseline patient status and, in some cases, especially when impairments are not present at baseline, provide interventions designed to improve physical and psychological health before the start of upcoming oncology treatments and reduce the likelihood of patients developing future impairments.
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95
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McDonnell KK, Bullock LF, Kozower BD, Hollen PJ, Heath J, Rovnyak V. A Decision Aid to Improve Smoking Abstinence for Families Facing Cancer. Oncol Nurs Forum 2014; 41:649-58. [DOI: 10.1188/14.onf.649-658] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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96
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Underner M, Peiffer G, Perriot J. Prise en charge du tabagisme. REVUE DES MALADIES RESPIRATOIRES ACTUALITÉS 2014. [DOI: 10.1016/s1877-1203(14)70585-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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97
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Smoking cessation dialogue and the complementary therapist: reluctance to engage? Complement Ther Clin Pract 2014; 20:181-7. [PMID: 25168007 DOI: 10.1016/j.ctcp.2014.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/23/2014] [Accepted: 07/29/2014] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Our aim was to explore the experiences and views of complementary therapists (CT) regarding smoking cessation (SC) support within the oncology setting. METHODS Two oncology sites participated in the North West of England. Three focus groups were conducted (n = 19) with resulting transcripts thematically analysed. Demographic data was collected via a short questionnaire. RESULTS Reasons were given for reluctance to engage in SC support, these included; fear of comprising the therapeutic relationship, patient's poor motivation and/or those living with life limiting disease. Nicotine Replacement Therapy (NRT) advice was regarded as a 'medical' activity. There was evidence of smoker-related stigmatisation. CONCLUSION This study provided insights in how complementary therapists view a potential SC role. Research is needed to determine whether the findings are common to other areas of CT practice. Further training in SC support is suggested for those working in oncology settings.
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98
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Dillman RO, McClure SE. Steadily improving survival in lung cancer. Clin Lung Cancer 2014; 15:331-7. [PMID: 25028337 DOI: 10.1016/j.cllc.2014.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/04/2014] [Accepted: 05/19/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND National data demonstrate minimal improvement in survival for patients diagnosed with lung cancer despite a number of apparent advances during the past 3 decades. We wished to know how demographic characteristics, staging, therapy, and survival have changed over time for patients with lung cancer who were accessioned to the cancer registry of a large community hospital in southern California. PATIENTS AND METHODS Clinical features and survival data were collected on patients diagnosed during each of the successive 6-year eras of 1986 to 1991 (n = 812), 1992 to 1997 (n = 1072), 1998 to 2003 (n = 1209), and 2004 to 2009 (n = 1365). RESULTS Median survival improved from 11 to 13 to 16 to 26 months and overall 5-year survival steadily improved from 16.5% to 19.1% to 24.0% to 31.1%. The proportion of patients with localized disease at diagnosis increased from 18.4% to 24.1% to 24.9% to 31.6%. Improvements in relative survival were much greater than have occurred nationally. Other obvious trends over time were increasing age of patients, increasing proportions with diagnoses of adenocarcinoma with concomitant decreases in squamous cell and small cell histologies, and decreases in the proportion of large cell carcinoma with reciprocal increases in neuroendocrine diagnoses. The use of chemotherapy for patients with local disease tripled in the most recent era. CONCLUSION Survival has steadily improved for patients in this community who were diagnosed with lung cancer. The explanations for this improvement are multifactorial, but include earlier stage at diagnosis, decreases in histologic types associated with active smoking, and increased use of systemic therapies.
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Affiliation(s)
- Robert O Dillman
- Hoag Institute for Research and Education; Hoag Family Cancer Institute, One Hoag Drive Building 41, Newport Beach, California, 92663.
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99
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Vaidya V, Hufstader-Gabriel M, Gangan N, Shah S, Bechtol R. Utilization of smoking-cessation pharmacotherapy among chronic obstructive pulmonary disease (COPD) and lung cancer patients. Curr Med Res Opin 2014; 30:1043-50. [PMID: 24432816 DOI: 10.1185/03007995.2014.884493] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Smoking is one of the major risk factors causing morbidity and mortality in chronic obstructive pulmonary disease (COPD) and lung cancer patients. Use of smoking cessation pharmacotherapy is an effective way to help quit smoking. The purpose of the study was to determine the prevalence of smoking and the proportion of patients using smoking cessation agents, and to identify the socio-demographic factors that affect the use of these agents among COPD and lung cancer patients. RESEARCH DESIGN AND METHODS A retrospective study was done to identify smokers having COPD (ICD-9: 490-492) or lung cancer (ICD-9: 162), and those who use smoking cessation agents from 2006-2010, using Medical Expenditure Panel Survey (MEPS) data. A multiple logistic regression model was built to identify significant socio-demographic predictors associated with the use of smoking cessation agents. RESULTS Around 16.8% of COPD patients and 15.1% of lung cancer patients reported smoking after diagnosis. Out of the total smokers, 8.8% patients with COPD and 12.6% patients with lung cancer reported use of smoking cessation agents during the 5 year period. Logistic regression showed that odds for smoking cessation use in COPD patients were lower for Hispanics (OR = 0.107, 95% CI 0.023-0.502) and higher for patients having insurance coverage (OR = 3.453, 95% CI 1.240-9.617). CONCLUSION Results showed that a large number of patients continued to smoke even after the diagnosis of COPD and lung cancer; whereas only a few among them used smoking cessation agents. Ethnicity disparities and insurance status were associated with the use of smoking cessation agents. Differential use among population sub-groups suggests a requirement for need based smoking cessation programs and appropriate prescription drug coverage. Further research needs to be done to evaluate reasons for disparities in smoking cessation agents' use. The study had limitations common to research designs based on observational and self-reported datasets.
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A role for cAMP-driven transactivation of EGFR in cancer aggressiveness - therapeutic implications. Med Hypotheses 2014; 83:142-7. [PMID: 24932579 DOI: 10.1016/j.mehy.2014.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 04/18/2014] [Accepted: 05/01/2014] [Indexed: 12/29/2022]
Abstract
In many common cancers, production of cAMP boosts cancer proliferation, survival, and aggressiveness, reflecting the fact that, through mechanisms that require further clarification, cAMP can promote tyrosine phosphorylation, notably transactivation of the epidermal growth factor receptor (EGFR). Hormones which activate adenylate cyclase in many cancers include PGE2 - often produced by cox-2 activity within tumors - and adrenergic hormones, acting on beta2 receptors. NSAID cyclooxygenase inhibitors, including low-dose aspirin, clearly reduce risk for many adenocarcinomas, but the impact of cox-2 inhibitors in clinical cancer therapy remains somewhat equivocal. There is increasing evidence that increased sympathetic drive, often reflecting psychic stress or tobacco usage, increases risk for, and promotes the aggressiveness of, many cancers. The non-specific beta antagonist propranolol shows cancer-retardant activity in pre-clinical rodent studies, especially in stressed animals, and a limited amount of epidemiology concludes that concurrent propranolol usage is associated with superior prognosis in breast cancer, ovarian cancer, and melanoma. Epidemiology correlating increased resting heart rate with increased total cancer mortality can be interpreted as compelling evidence that increased sympathetic drive encourages the onset and progression of common cancers. Conversely, hormones which inhibit adenylate cyclase activity in cancers may have potential for cancer control; GABA, which can be administered as a well-tolerated nutraceutical, has potential in this regard. Combination regimens intended to down-regulate cancer cAMP levels, perhaps used in conjunction with EGFR inhibitors, may have considerable potential for suppressing the contribution of cAMP/EGFR to cancer aggressiveness. This model also predicts that certain other hormones which activate adenylate cylase in various tissue may play a yet-unsuspected role in cancer induction and spread.
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