1
|
Visscher J, Hiwase M, Bonevski B, O'Callaghan M. The association of smoking with urinary and sexual function recovery following radical prostatectomy for localized prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2024; 27:222-229. [PMID: 37500786 DOI: 10.1038/s41391-023-00701-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Urinary and sexual dysfunction after radical prostatectomy remains a major cause of morbidity, despite widespread availability of pharmacological and rehabilitative treatments. Smoking is a modifiable risk factor known to correlate with erectile and urinary dysfunction and we hypothesise that smoking cessation may improve post-prostatectomy urinary and sexual function recovery. Our objective is to systematically evaluate literature describing the association of smoking status with urinary and sexual function in men following radical prostatectomy. METHODS In total, 310 unique records were identified through a systematic search of the MEDLINE, EMBASE, Scopus, Web of Science, CINAHL and CENTRAL databases up to February 2023. Nine studies reported smoking status and post radical prostatectomy urinary and sexual function outcomes in men with localized prostate cancer. Risk of bias was assessed and meta-analysis included six studies. RESULTS Smokers had inferior erectile function after prostatectomy compared to non-smokers (OR 0.73, [95% CI 0.56-0.95]) during follow-up, while urinary incontinence was not statistically different between groups (OR 1.20, [95% CI 0.75-1.91]). Smoking cessation improved the EPIC-26 sexual domain score with 6.6 points on average [p = 0.03] to a clinically significant maximum of 12.5 points at 18-24 months. CONCLUSIONS Smoking is associated with impaired sexual function recovery after radical prostatectomy and quitting may improve sexual function >18 months. Current evidence shows no such association for urinary outcomes. Further studies are needed to corroborate findings.
Collapse
Affiliation(s)
- Jordi Visscher
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
| | - Mrunal Hiwase
- Department of Surgery, Central Adelaide Health Network, Adelaide, SA, Australia
| | - Billie Bonevski
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Michael O'Callaghan
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Flinders Medical Centre, Urology Unit, Adelaide, SA, Australia
| |
Collapse
|
2
|
Wang X, Zeng M, Ju X, Lin A, Zhou C, Shen J, Liu Z, Tang B, Cheng Q, Wang Y, Zhang J, Luo P. Correlation between second and first primary cancer: systematic review and meta-analysis of 9 million cancer patients. Br J Surg 2024; 111:znad377. [PMID: 38055899 DOI: 10.1093/bjs/znad377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/30/2023] [Accepted: 10/21/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Many survivors of a first primary cancer (FPCs) are at risk of developing a second primary cancer (SPC), with effects on patient prognosis. Primary cancers have different frequencies of specific SPC development and the development of SPCs may be closely related to the FPC. The aim of this study was to explore possible correlations between SPCs and FPCs. METHODS Relevant literature on SPCs was retrospectively searched and screened from four databases, namely, PubMed, EMBASE, Web of Science, and PMC. Data on the number of patients with SPC in 28 different organ sites were also collected from The Surveillance, Epidemiology, and End Results (SEER) 8 Registry and NHANES database. RESULTS A total of 9 617 643 patients with an FPC and 677 430 patients with an SPC were included in the meta-analysis. Patients with a first primary gynaecological cancer and thyroid cancer frequently developed a second primary breast cancer and colorectal cancer. Moreover, those with a first primary head and neck cancer, anal cancer and oesophageal cancer developed a second primary lung cancer more frequently. A second primary lung cancer and prostate cancer was also common among patients with first primary bladder cancer and penile cancer. Patients with second primary bladder cancer accounted for 56% of first primary ureteral cancer patients with SPCs. CONCLUSIONS This study recommends close clinical follow-up, monitoring and appropriate interventions in patients with relevant FPCs for better screening and early diagnosis of SPCs.
Collapse
Affiliation(s)
- Xinyu Wang
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Meiyuan Zeng
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xueming Ju
- Department of Utrsound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Anqi Lin
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Chaozheng Zhou
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Junyi Shen
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zaoqu Liu
- State Key Laboratory of Proteomics, Beijing Proteome Research Center, National Center for Protein Sciences (Beijing), Beijing Institute of Lifeomics, Beijing, China
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bufu Tang
- Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Quan Cheng
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, P. R. China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
| | - Youyu Wang
- Department of Utrsound, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jian Zhang
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Peng Luo
- Department of Oncology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| |
Collapse
|
3
|
Mossanen M, Smith AB, Onochie N, Matulewicz R, Bjurlin MA, Kibel AS, Abbas M, Shore N, Chisolm S, Bangs R, Cooper Z, Gore JL. Bladder cancer patient and provider perspectives on smoking cessation. Urol Oncol 2023; 41:457.e9-457.e16. [PMID: 37805339 DOI: 10.1016/j.urolonc.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Smoking is the most common risk factor for bladder cancer and is associated with adverse clinical and cancer-related outcomes. Increasing understanding of the patient and provider perspectives on smoking cessation may provide insight into improving smoking cessation rates among bladder cancer survivors. We sought to inform strategies for providers promoting cessation efforts and help patients quit smoking. METHODS Using a modified Delphi process with multidisciplinary input from bladder cancer providers, researchers, and a patient advocate, 2 surveys were created for bladder cancer patients and providers. Surveys included multiple-choice questions and free answers. The survey was administered electronically and queried participants' perspectives on barriers and facilitators associated with smoking cessation. Survey responses were anonymous, and participants were provided with a $20 Amazon gift card for participating. Patients were approached through the previously established Bladder Cancer Advocacy Network (BCAN) Patient Survey Network, an online bladder cancer patient and caregiver community. Providers were recruited from the Society of Urologic Oncology (SUO) and the Large Urology Group Practice Association (LUGPA). RESULTS From May to June 2021, 308 patients and 103 providers completed their respective surveys. Among patients who quit smoking, most (64%) preferred no pharmacologic intervention ("cold turkey") followed by nicotine replacement therapy (28%). Repeated efforts at cessation commonly occurred, and 67% reported making more than one attempt at quitting prior to eventual smoking cessation. Approximately 1 in 10 patients were unaware of the association between bladder cancer and smoking. Among providers, 75% felt that barriers to provide cessation include a lack of clinical time, adequate training, and reimbursement concerns. However, 79% of providers endorsed a willingness to receive continuing education on smoking cessation. CONCLUSIONS Bladder cancer patients utilize a variety of cessation strategies with "cold turkey" being the most used method, and many patients make multiple attempts at smoking cessation. Providers confront multiple barriers to conducting smoking cessation, including inadequate time and training in cessation methods; however, most would be willing to receive additional education. These results inform future interventions tailored to bladder cancer clinicians to better support provider efforts to provide smoking cessation counseling.
Collapse
Affiliation(s)
- Matthew Mossanen
- Division of Urology, Brigham and Women's Hospital, Boston, MA; Department of Surgery, Center for Surgery and Public Health, Boston, MA; Lank Center for Genitourinary Oncology, Dana Farber Cancer Institute, Boston MA.
| | - Angela B Smith
- Department of Urology, University of North Caroline at Chapel Hill School of Medicine, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, University of North Caroline at Chapel Hill, NC
| | | | - Richard Matulewicz
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Marc A Bjurlin
- Department of Urology, University of North Caroline at Chapel Hill School of Medicine, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, University of North Caroline at Chapel Hill, NC
| | - Adam S Kibel
- Division of Urology, Brigham and Women's Hospital, Boston, MA
| | - Muhammad Abbas
- Department of Surgery, Center for Surgery and Public Health, Boston, MA
| | - Neal Shore
- GenesisCare, Carolina Urologic Research Center, Myrtle Beach, SC
| | | | - Rick Bangs
- GenesisCare, Carolina Urologic Research Center, Myrtle Beach, SC; Bladder Cancer Advocacy Network, Bethesda, MD
| | - Zara Cooper
- Department of Surgery, Center for Surgery and Public Health, Boston, MA; Department of Surgery, Brigham and Women's Hospital, Boston, MA
| | - John L Gore
- Department of Urology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA
| |
Collapse
|
4
|
Kumar R, Matulewicz R, Mari A, Moschini M, Ghodoussipour S, Pradere B, Rink M, Autorino R, Desai MM, Gill I, Cacciamani GE. Impact of smoking on urologic cancers: a snapshot of current evidence. World J Urol 2023; 41:1473-1479. [PMID: 37093319 PMCID: PMC10241723 DOI: 10.1007/s00345-023-04406-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/06/2023] [Indexed: 04/25/2023] Open
Abstract
PURPOSE The purpose of this paper is to present evidence regarding the associations between smoking and the following urologic cancers: prostate, bladder, renal, and upper tract urothelial cancer (UTUC). METHODS This is a narrative review. PubMed was queried for evidence-based analyses and trials regarding the associations between smoking and prostate, bladder, renal, and UTUC tumors from inception to September 1, 2022. Emphasis was placed on articles referenced in national guidelines and protocols. RESULTS Prostate-multiple studies associate smoking with higher Gleason score, higher tumor stage, and extracapsular invasion. Though smoking has not yet been linked to tumorigenesis, there is evidence that it plays a role in biochemical recurrence and cancer-specific mortality. Bladder-smoking is strongly associated with bladder cancer, likely due to DNA damage from the release of carcinogenic compounds. Additionally, smoking has been linked to increased cancer-specific mortality and higher risk of tumor recurrence. Renal-smoking tobacco has been associated with tumorigenesis, higher tumor grade and stage, poorer mortality rates, and a greater risk of tumor recurrence. UTUC-tumorigenesis has been associated with smoking tobacco. Additionally, more advanced disease, higher stage, lymph node metastases, poorer survival outcomes, and tumor recurrence have been linked to smoking. CONCLUSION Smoking has been shown to significantly affect most urologic cancers and has been associated with more aggressive disease, poorer outcomes, and tumor recurrence. The role of smoking cessation is still unclear, but appears to provide some protective effect. Urologists have an opportunity to engage in primary prevention by encouraging cessation practices.
Collapse
Affiliation(s)
- Raj Kumar
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Richard Matulewicz
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrea Mari
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Moschini
- Department of Urology, La Croix du Sud Hospital, 31130, Quint Fonsegrives, France
| | - Saum Ghodoussipour
- Bladder and Urothelial Cancer Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Riccardo Autorino
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Mihir M Desai
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Inderbir Gill
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Giovanni E Cacciamani
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA.
| |
Collapse
|
5
|
Ślusarczyk A, Zapała P, Zapała Ł, Radziszewski P. The impact of smoking on recurrence and progression of non-muscle invasive bladder cancer: a systematic review and meta-analysis. J Cancer Res Clin Oncol 2023; 149:2673-2691. [PMID: 36404390 PMCID: PMC10129946 DOI: 10.1007/s00432-022-04464-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 11/02/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Although smoking is a well-recognized causative factor of urothelial bladder cancer and accounts for 50% of cases, less is known about the prognostic significance of smoking on non-muscle invasive bladder cancer (NMIBC) prognosis. This systematic review and meta-analysis aimed to evaluate the effect of smoking on the risk of NMIBC recurrence and progression. MATERIALS AND METHODS We systematically searched Medline, Web of Science and Scopus databases for original articles published before October 2021 regarding the effect of smoking on NMIBC recurrence and progression. Information about smoking status and the number of events or odds ratio or hazard ratio for event-free survival must have been reported to include the study in the analysis. Quality In Prognosis Studies tool was utilized for the risk of bias assessment. RESULTS We selected 64 eligible studies, including 28 617 patients with NMIBC with available data on smoking status. In a meta-analysis of 28 studies with 7885 patients, we found that smokers (current/former) were at higher risk for recurrence (OR = 1.68; 95% CI 1.34-2.09; P < 0.0001) compared to never smokers. Subgroup analysis of 2967 patients revealed that current smokers were at a 1.24 higher risk of recurrence (OR = 1.24; 95% CI 1.02-1.50; P = 0.03) compared to former smokers. A meta-analysis of the hazard ratio revealed that smokers are at higher risk of recurrence (HR = 1.31; 95%CI 1.15-1.48; P < 0.0001) and progression (HR = 1.18; 95%CI 1.08-1.29; P < 0.001) compared to never smokers. Detrimental prognostic effect of smoking on progression, but not for recurrence risk was also noted in the subgroup analysis of high-risk patients (HR = 1.30; 95%CI 1.09-1.55; P = 0.004) and BCG-treated ones (HR = 1.15; 95%CI 1.06-1.25; P < 0.001). CONCLUSION In conclusion, patients with non-muscle invasive bladder cancer and a history of smoking have a worse prognosis regarding recurrence-free and progression-free survival compared to non-smokers.
Collapse
Affiliation(s)
- Aleksander Ślusarczyk
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
| | - Piotr Zapała
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland.
| | - Łukasz Zapała
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland
| | - Piotr Radziszewski
- Department of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005, Warsaw, Poland
| |
Collapse
|
6
|
Lobo N, Afferi L, Moschini M, Mostafid H, Porten S, Psutka SP, Gupta S, Smith AB, Williams SB, Lotan Y. Epidemiology, Screening, and Prevention of Bladder Cancer. Eur Urol Oncol 2022; 5:628-639. [PMID: 36333236 DOI: 10.1016/j.euo.2022.10.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/09/2022] [Accepted: 10/10/2022] [Indexed: 11/05/2022]
Abstract
CONTEXT Bladder cancer (BC) represents a significant health problem due to the potential morbidity and mortality associated with disease burden, which has remained largely unaltered over time. OBJECTIVE To provide an expert collaborative review and describe the incidence, prevalence, and mortality of BC and to evaluate current evidence for BC screening and prevention. EVIDENCE ACQUISITION Data on the estimated incidence and mortality of BC for 2020 in 185 countries were derived from the International Agency for Research on Cancer GLOBOCAN database. A review of English-language articles published over the past 5 yr was conducted using PubMed/MEDLINE to identify risk factors in addition to contemporary evidence on BC screening and prevention. EVIDENCE SYNTHESIS BC is the tenth most common cancer worldwide, with 573 278 cases in 2020. BC incidence is approximately fourfold higher in men than women. Tobacco smoking remains the principal risk factor, accounting for approximately 50% of cases. There is insufficient evidence to recommend routine BC screening. However, targeted screening of high-risk individuals (defined according to smoking history or occupational exposure) may reduce BC mortality and should be the focus of prospective randomized trials. In terms of disease prevention, smoking cessation represents the most important intervention, followed by a reduction in exposure to occupational and environmental carcinogens. CONCLUSIONS BC confers a significant disease burden. An understanding of BC epidemiology and risk factors provides an optimal foundation for disease prevention and the care of affected patients. PATIENT SUMMARY Bladder cancer is the tenth most common cancer worldwide and is approximately four times more common among men than among women. The main risk factors are tobacco smoking, followed by exposure to carcinogens in the workplace or the environment. Routine screening is not currently recommended, but may be beneficial in individuals at high risk, such as heavy smokers. Primary prevention is extremely important, and smoking cessation represents the most important action for reducing bladder cancer cases and deaths.
Collapse
Affiliation(s)
- Niyati Lobo
- Royal Surrey NHS Foundation Trust, Guildford, UK
| | | | - Marco Moschini
- Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Sima Porten
- University of California-San Francisco, San Francisco, CA, USA
| | - Sarah P Psutka
- University of Washington, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | | | - Angela B Smith
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | | | - Yair Lotan
- University of Texas Southwestern Medical Centre, Dallas, TX, USA.
| |
Collapse
|
7
|
Kwan ML, Haque R, Young-Wolff KC, Lee VS, Roh JM, Ergas IJ, Wang Z, Cannavale KL, Ambrosone CB, Loo RK, Aaronson DS, Quesenberry CP, Kushi LH, Tang L. Smoking Behaviors and Prognosis in Patients With Non-Muscle-Invasive Bladder Cancer in the Be-Well Study. JAMA Netw Open 2022; 5:e2244430. [PMID: 36449286 PMCID: PMC9713602 DOI: 10.1001/jamanetworkopen.2022.44430] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/17/2022] [Indexed: 12/05/2022] Open
Abstract
Importance Tobacco smoking is an established risk factor associated with bladder cancer, yet its impact on bladder cancer prognosis is unclear. Objective To examine associations of use of tobacco (cigarettes, pipes, and cigars), e-cigarettes, and marijuana with risk of recurrence and progression of non-muscle-invasive bladder cancer (NMIBC) and to explore use of smoking cessation interventions. Design, Setting, and Participants The Be-Well Study is a prospective cohort study of patients with NMIBC diagnosed from 2015 to 2019 and followed-up for 26.4 months in the Kaiser Permanente Northern and Southern California integrated health care system. Eligibility criteria were age at least 21 years, first NMIBC diagnosis (stages Ta, Tis, or T1), alive, and not in hospice care. Exclusion criteria were previous diagnosis of bladder cancer or other cancer diagnoses within 1 year prior to or concurrent with NMIBC diagnosis. Data were analyzed from April 1 to October 4, 2022. Exposures Use of cigarettes, pipes, cigars, e-cigarettes, and marijuana was reported in the baseline interview. Use of smoking cessation interventions (counseling and medications) was derived from electronic health records. Main Outcomes and Measures Hazard ratios (HRs) and 95% CIs of recurrence and progression of bladder cancer were estimated by multivariable Cox proportional hazards regression. Results A total of 1472 patients (mean [SD] age at diagnosis, 70.2 [10.8%] years; 1129 [76.7%] male patients) with NMIBC were enrolled at a mean (SD) of 2.3 (1.3) months after diagnosis, including 874 patients (59.4%) who were former smokers and 111 patients (7.5%) who were current cigarette smokers; 67 patients (13.7%) smoked pipes and/or cigars only, 65 patients (4.4%) used e-cigarettes, 363 patients (24.7%) used marijuana. Longer cigarette smoking duration and more pack-years were associated with higher risk of recurrence in a dose-dependent manner, with the highest risks for patients who had smoked for 40 or more years (HR, 2.36; 95% CI, 1.43-3.91) or 40 or more pack-years (HR, 1.97; 95% CI, 1.32-2.95). There was no association of having ever smoked, being a former or current cigarette smoker, and years since quit smoking with recurrence risk. No associations with pipes, cigars, e-cigarettes, or marijuana were found. Of 102 patients offered a smoking cessation intervention, 57 (53.8%) received an interventions after diagnosis, with female patients more likely than male patients to engage in such interventions (23 of 30 female patients [76.7%] vs 34 of 76 male patients [44.7%]; P = .003). Conclusions and Relevance These findings suggest that longer duration and more pack-years of cigarette smoking were associated with higher risk of NMIBC recurrence. Cigarette smoking remains a critical exposure before and after diagnosis in survivors of NMIBC.
Collapse
Affiliation(s)
- Marilyn L. Kwan
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Reina Haque
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | | | - Valerie S. Lee
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Janise M. Roh
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Isaac J. Ergas
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Zinian Wang
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Kimberly L. Cannavale
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena
| | - Christine B. Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Ronald K. Loo
- Department of Urology, Kaiser Permanente Downey Medical Center, Downey, California
| | - David S. Aaronson
- Department of Urology, Kaiser Permanente Oakland Medical Center, Oakland, California
| | | | - Lawrence H. Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Li Tang
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| |
Collapse
|
8
|
Tsemach R, Enden‐Izhaki A, Amit Aharon A. Intervention training of urology healthcare staff to counsel acute care inpatients on smoking cessation: An evaluation study. Nurs Open 2022; 10:828-837. [PMID: 36059078 PMCID: PMC9834151 DOI: 10.1002/nop2.1351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 07/24/2022] [Accepted: 08/22/2022] [Indexed: 01/16/2023] Open
Abstract
AIM To evaluate the differences, following intervention training, in the knowledge, attitudes, role perception, self-capacity and intention of urology staff to counsel inpatients on smoking cessation. DESIGN A descriptive evaluation study of intervention training in counselling on smoking cessation. The study was designed following guidance by the Medical Research Council. METHODS The evaluation was based on a closed-end questionnaire with four time-point measurements from May 2018-December 2019 (N = 29 at each time-point). A repeated measure within-subjects ANOVA was conducted to explore the variance in participants' attitudes, role perception, self-capacity and intention to counsel patients regarding smoking cessation. Eta squared and Bonferroni post hoc tests were used to interpret the results. RESULTS No change was observed in the research variables after theoretical science-based learning of the smoking hazards and the benefits of cessation. A statistically significant difference was found following procedural knowledge based on training, practical experience and skill development.
Collapse
Affiliation(s)
- Ronit Tsemach
- Urology DepartmentTel Aviv Sourasky Medical CenterTel AvivIsrael,Nursing Department, Steyer School of Health Professions, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| | - Anat Enden‐Izhaki
- Macabi Health ServicesSecretary of the Israel Medical Association for Smoking Prevention and CessationTel AvivIsrael
| | - Anat Amit Aharon
- Nursing Department, Steyer School of Health Professions, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
| |
Collapse
|
9
|
Affentranger A, Matulewicz RS, Fankhauser CD. Why and How Smoking Cessation Must Be Implemented in Urology Clinics as a Standard of Care. Eur Urol 2022; 82:245-246. [PMID: 35525775 DOI: 10.1016/j.eururo.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 04/19/2022] [Indexed: 11/04/2022]
Abstract
Smoking cessation is a cost-efficient and important intervention in urology. Implementation studies are required to identify how support for smoking cessation can be successfully introduced in daily clinical routine in urology.
Collapse
Affiliation(s)
- Andres Affentranger
- Department of Urology, Cantonal Hospital of Lucerne, Lucerne, Switzerland; University of Zurich, Zurich, Switzerland
| | - Richard S Matulewicz
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | |
Collapse
|
10
|
Matulewicz RS, Bassett JC, Kwan L, Sherman SE, McCarthy WJ, Saigal CS, Gore JL. Using a multilevel implementation strategy to facilitate the screening and treatment of tobacco use in the outpatient urology clinic: A prospective hybrid type I study. Cancer 2021; 128:1184-1193. [PMID: 34875105 DOI: 10.1002/cncr.34054] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Urologists frequently treat patients for tobacco-related conditions but infrequently engage in evidence-based practices (EBPs) that screen for and treat tobacco use. Improving the use of EBPs will help to identify smokers, promote cessation, and improve patients' health outcomes. METHODS A prospective type I hybrid effectiveness-implementation study was performed to test the feasibility and effectiveness of using a multilevel implementation strategy to improve the use of tobacco EBPs. All urology providers at outpatient urology clinics within the Veterans Health Administration Greater Los Angeles and all patients presenting for a new urology consultation were included. The primary outcome was whether a patient was screened for tobacco use at the time of consultation. Secondary outcomes included a patient's willingness to quit, chosen quit strategy, and subsequent engagement in quit attempts. RESULTS In total, 5706 consecutive veterans were seen for a new consultation during the 30-month study period. Thirty-six percent of all visits were for a tobacco-related urologic diagnosis. The percentage of visits that included tobacco use screening increased from 18% (before implementation) to 57% in the implementation phase and to 60% during the maintenance phase. There was significant provider-level variation in adherence to screening. Of all screened patients, 38% were willing to quit, and most patients chose a "cold turkey" method; 22% of the patients elected referral to a formal smoking cessation clinic, and 24% chose telephone counseling. Among those willing to quit, 39% and 49% made a formal quit attempt by 3 and 6 months, respectively. CONCLUSIONS A strategy that includes provider education and a customized clinical decision support tool can facilitate provider use of tobacco EBPs in a surgery subspecialty clinic.
Collapse
Affiliation(s)
- Richard S Matulewicz
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York.,VA New York Harbor Healthcare System, New York, New York
| | - Jeffrey C Bassett
- Hoag Urologic Oncology, Hoag Health Network, Newport Beach, California
| | - Lorna Kwan
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Scott E Sherman
- VA New York Harbor Healthcare System, New York, New York.,Department of Population Health, New York University, New York, New York
| | - William J McCarthy
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California.,Department of Psychology, University of California Los Angeles, Los Angeles, California
| | - Christopher S Saigal
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - John L Gore
- Department of Urology, University of Washington School of Medicine, Seattle, Washington
| |
Collapse
|
11
|
Thomas KH, Dalili MN, López-López JA, Keeney E, Phillippo D, Munafò MR, Stevenson M, Caldwell DM, Welton NJ. Smoking cessation medicines and e-cigarettes: a systematic review, network meta-analysis and cost-effectiveness analysis. Health Technol Assess 2021; 25:1-224. [PMID: 34668482 DOI: 10.3310/hta25590] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cigarette smoking is one of the leading causes of early death. Varenicline [Champix (UK), Pfizer Europe MA EEIG, Brussels, Belgium; or Chantix (USA), Pfizer Inc., Mission, KS, USA], bupropion (Zyban; GlaxoSmithKline, Brentford, UK) and nicotine replacement therapy are licensed aids for quitting smoking in the UK. Although not licensed, e-cigarettes may also be used in English smoking cessation services. Concerns have been raised about the safety of these medicines and e-cigarettes. OBJECTIVES To determine the clinical effectiveness, safety and cost-effectiveness of smoking cessation medicines and e-cigarettes. DESIGN Systematic reviews, network meta-analyses and cost-effectiveness analysis informed by the network meta-analysis results. SETTING Primary care practices, hospitals, clinics, universities, workplaces, nursing or residential homes. PARTICIPANTS Smokers aged ≥ 18 years of all ethnicities using UK-licensed smoking cessation therapies and/or e-cigarettes. INTERVENTIONS Varenicline, bupropion and nicotine replacement therapy as monotherapies and in combination treatments at standard, low or high dose, combination nicotine replacement therapy and e-cigarette monotherapies. MAIN OUTCOME MEASURES Effectiveness - continuous or sustained abstinence. Safety - serious adverse events, major adverse cardiovascular events and major adverse neuropsychiatric events. DATA SOURCES Ten databases, reference lists of relevant research articles and previous reviews. Searches were performed from inception until 16 March 2017 and updated on 19 February 2019. REVIEW METHODS Three reviewers screened the search results. Data were extracted and risk of bias was assessed by one reviewer and checked by the other reviewers. Network meta-analyses were conducted for effectiveness and safety outcomes. Cost-effectiveness was evaluated using an amended version of the Benefits of Smoking Cessation on Outcomes model. RESULTS Most monotherapies and combination treatments were more effective than placebo at achieving sustained abstinence. Varenicline standard plus nicotine replacement therapy standard (odds ratio 5.75, 95% credible interval 2.27 to 14.90) was ranked first for sustained abstinence, followed by e-cigarette low (odds ratio 3.22, 95% credible interval 0.97 to 12.60), although these estimates have high uncertainty. We found effect modification for counselling and dependence, with a higher proportion of smokers who received counselling achieving sustained abstinence than those who did not receive counselling, and higher odds of sustained abstinence among participants with higher average dependence scores. We found that bupropion standard increased odds of serious adverse events compared with placebo (odds ratio 1.27, 95% credible interval 1.04 to 1.58). There were no differences between interventions in terms of major adverse cardiovascular events. There was evidence of increased odds of major adverse neuropsychiatric events for smokers randomised to varenicline standard compared with those randomised to bupropion standard (odds ratio 1.43, 95% credible interval 1.02 to 2.09). There was a high level of uncertainty about the most cost-effective intervention, although all were cost-effective compared with nicotine replacement therapy low at the £20,000 per quality-adjusted life-year threshold. E-cigarette low appeared to be most cost-effective in the base case, followed by varenicline standard plus nicotine replacement therapy standard. When the impact of major adverse neuropsychiatric events was excluded, varenicline standard plus nicotine replacement therapy standard was most cost-effective, followed by varenicline low plus nicotine replacement therapy standard. When limited to licensed interventions in the UK, nicotine replacement therapy standard was most cost-effective, followed by varenicline standard. LIMITATIONS Comparisons between active interventions were informed almost exclusively by indirect evidence. Findings were imprecise because of the small numbers of adverse events identified. CONCLUSIONS Combined therapies of medicines are among the most clinically effective, safe and cost-effective treatment options for smokers. Although the combined therapy of nicotine replacement therapy and varenicline at standard doses was the most effective treatment, this is currently unlicensed for use in the UK. FUTURE WORK Researchers should examine the use of these treatments alongside counselling and continue investigating the long-term effectiveness and safety of e-cigarettes for smoking cessation compared with active interventions such as nicotine replacement therapy. STUDY REGISTRATION This study is registered as PROSPERO CRD42016041302. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 59. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Kyla H Thomas
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Michael N Dalili
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - José A López-López
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Edna Keeney
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - David Phillippo
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus R Munafò
- Faculty of Life Sciences, School of Psychological Science, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,UK Centre for Tobacco and Alcohol Studies, University of Bristol, Bristol, UK
| | - Matt Stevenson
- Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Deborah M Caldwell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicky J Welton
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
12
|
Cacciamani GE, Matulewicz RS, Kumar R, Teoh JYC, Mari A, Pradere B, Gomez Rivas J, Necchi A, Kumar Pal S, Ribal MJ, Shariat S, Rink M. Fighting the 'tobacco epidemic' - A call to action to identify Targeted Intervention Points (TIPs) for better counseling patients with urothelial cancer. Urol Oncol 2021; 39:793-796. [PMID: 34629283 DOI: 10.1016/j.urolonc.2021.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/04/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
The association between tobacco use and urothelial cancer of the bladder is well known. Given the worsening tobacco epidemic, here we make the case for systematic targeted points of intervention for urologists and other professionals to intervene against bladder cancer. Awareness of contemporary checkpoints where we can intervene for counseling patients may help medical education in a tobacco-pandemic difficult setting.
Collapse
Affiliation(s)
- Giovanni E Cacciamani
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles.
| | - Richard S Matulewicz
- Departments of Urology and Population Health, NYU Grossman School of Medicine, New York, NY
| | - Raj Kumar
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Andrea Mari
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Juan Gomez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
| | - Andrea Necchi
- Department of Medical Oncology, Vita-Salute San Raffaele University & IRCCS San Raffaele Hospital, Milan, Italy
| | - Sumanta Kumar Pal
- Department of Medical Oncology & Experimental Therapeutics, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Maria J Ribal
- Uro-Oncology Unit. Hospital Clinic. University of Barcelona, Spain
| | - Shahrokh Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Departments of Urology, Weill Cornell Medical College, New York, NY; Department of Urology, University of Texas Southwestern, Dallas, TX; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | |
Collapse
|
13
|
Bjurlin MA, Matulewicz RS, Roberts TR, Dearing BA, Schatz D, Sherman S, Gordon T, Shahawy OE. Carcinogen Biomarkers in the Urine of Electronic Cigarette Users and Implications for the Development of Bladder Cancer: A Systematic Review. Eur Urol Oncol 2021; 4:766-783. [PMID: 32192941 DOI: 10.1016/j.euo.2020.02.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 01/19/2020] [Accepted: 02/13/2020] [Indexed: 02/06/2023]
Abstract
CONTEXT Use of electronic cigarettes (e-cigarettes) has rapidly increased despite unclear longitudinal health effects. Once thought to be a safer alternative to tobacco smoke, it is possible that e-cigarettes expose the user to similar carcinogenic byproducts during the vaping process. These toxicants are metabolized and excreted in the urine, and may have oncogenic implications for bladder urothelium. OBJECTIVE To characterize and summarize known urinary carcinogenic biomarkers in e-cigarette users as they relate to the risk of developing bladder cancer. EVIDENCE ACQUISITION A systematic literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and included PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL). Relevant articles published in peer-reviewed journals, through January 2019, that reported on urinary biomarkers in e-cigarettes users were included. Parent compounds and urinary biomarkers were classified according to the International Agency for Research on Cancer Monographs on the Evaluation of Carcinogenic Risks to Humans and cross referenced using the Collaborative on Health and the Environment, Toxicant and Disease Database to determine a link to bladder cancer, grouped by strength of evidence. EVIDENCE SYNTHESIS Our initial search identified 1385 articles, 22 of which met final inclusion criteria and were included for analysis. In summation, these studies described 40 different parent compounds and four metals found in the urine of e-cigarette users. Since each parent compound can be metabolized several different ways, 63 unique toxicant or carcinogenic metabolite biomarkers were identified. Compared with nonuser controls, e-cigarette users had higher concentrations of urinary biomarkers of several carcinogenic compounds linked to bladder cancer. The majority of studies were limited by heterogeneous reporting and a dearth of control individuals who had never smoked. CONCLUSIONS Biomarkers of carcinogens, several with a strong link to bladder cancer, are present in the urine of e-cigarette users. Long-term implications of urothelial exposure to these toxicants are unknown but concerning, given the similarities to tobacco smoke and its established relationship with bladder cancer. Further study on the urological safety of e-cigarettes is necessary. PATIENT SUMMARY Our review shows that several carcinogens that have a known link to bladder cancer are present in the urine of electronic cigarette (e-cigarette) users. Further study on the urological safety of e-cigarettes is necessary.
Collapse
Affiliation(s)
- Marc A Bjurlin
- Department of Urology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
| | | | | | - Bianca A Dearing
- Section on Tobacco, Alcohol and Drug Use, Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Daniel Schatz
- Section on Tobacco, Alcohol and Drug Use, Department of Population Health, NYU School of Medicine, New York, NY, USA; Office of Behavioral Health, Health + Hospitals, New York, NY, USA
| | - Scott Sherman
- Section on Tobacco, Alcohol and Drug Use, Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Terry Gordon
- Department of Environmental Medicine, New York University, New York, NY, USA
| | - Omar El Shahawy
- Section on Tobacco, Alcohol and Drug Use, Department of Population Health, NYU School of Medicine, New York, NY, USA
| |
Collapse
|
14
|
Brake L, Myrie A, Zhao C, Feuer Z, Taylor J, Bjurlin MA, Sherman SE, Makarov DV, Matulewicz RS. Population-Level Assessment of Smoking-Related Beliefs and Behaviors Among Survivors of Genitourinary Cancers: An Application of the Theory of Planned Behavior. Urology 2021; 154:215-220. [PMID: 33577901 DOI: 10.1016/j.urology.2021.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/11/2020] [Accepted: 01/27/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To describe attitudes, perceptions, and beliefs related to smoking and smoking cessation among survivors of genitourinary cancers using a theory-based framework. METHODS We performed a cross-sectional analysis of Wave III of the PATH study, a prospective cohort survey study assessing tobacco-use patterns and attitudes among a representative population-based sample of US adults. All adult current smokers with a history of urologic cancer were included. Primary outcomes were mapped to components of the Theory of Planned Behavior (TPB) and included: attempts to quit, readiness to quit, plan to quit, being told to quit, peers views toward smoking, regret about smoking, the perceived relationship between smoking and cancer/overall health. Secondary outcomes include: time to first cigarette, utilization of smoking cessation aids. Population weighted percentages with 95% confidence intervals were estimated. RESULTS Our cohort represents a population estimate of 461,182 adult current smokers with a history of genitourinary cancer. The majority of respondents (90%) perceived smoking to be harmful to one's health and 83% were regretful about having started smoking. An equal proportion of respondents indicated that they were "very ready to quit," "somewhat ready to quit," or "not ready to quit." Among all respondents, 73% had been told by a physician to quit in the past year but only 7% indicated that they had used prescription medication and only 21% had used nicotine replacement therapy to help with smoking cessation. CONCLUSION There is significant variation in attitudes, behaviors, and perceptions related to smoking and smoking cessation among survivors of genitourinary malignancy. Patient-level smoking cessation interventions may need to be highly personalized for optimal success.
Collapse
Affiliation(s)
- Lee Brake
- NYU Grossman School of Medicine, Department of Urology, New York, NY
| | - Akya Myrie
- SUNY Downstate Health Sciences University, Department of Urology, New York, NY
| | - Calvin Zhao
- NYU Grossman School of Medicine, Department of Population Health, New York, NY
| | - Zach Feuer
- NYU Grossman School of Medicine, Department of Urology, New York, NY; VA New York Harbor Health System, New York, NY
| | - Jacob Taylor
- NYU Grossman School of Medicine, Department of Urology, New York, NY; VA New York Harbor Health System, New York, NY
| | | | - Scott E Sherman
- NYU Grossman School of Medicine, Department of Population Health, New York, NY; VA New York Harbor Health System, New York, NY
| | - Danil V Makarov
- NYU Grossman School of Medicine, Department of Urology, New York, NY; NYU Grossman School of Medicine, Department of Population Health, New York, NY; VA New York Harbor Health System, New York, NY
| | - Richard S Matulewicz
- NYU Grossman School of Medicine, Department of Urology, New York, NY; NYU Grossman School of Medicine, Department of Population Health, New York, NY; VA New York Harbor Health System, New York, NY.
| |
Collapse
|
15
|
Jensen BT, Lauridsen SV, Scheede-Bergdahl C. The Potential of Prehabilitation in Radical Cystectomy Pathways: Where Are We Now? Semin Oncol Nurs 2021; 37:151107. [PMID: 33446382 DOI: 10.1016/j.soncn.2020.151107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The growing recognition of prehabilitation has caused an emerging paradigm shift in surgical cancer care and an integrated component of the cancer care continuum. This narrative review aims to update and inform the urological community of the potential of prehabilitation before radical cystectomy. DATA SOURCES A nonsystematic narrative review was performed through a database search in PubMed, and CINAHL using the following search terms: enhanced recovery after surgery (ERAS); Frailty; Prehabilitation and/or Rehabilitation; Physical Activity and/or exercises; Nutrition; Nutritional Care; Smoking cessation; Alcohol cessation; Prevention; Supportive Care; and combined with Radical Cystectomy. CONCLUSION A multimodal and multi-professional approach during the preoperative period may offer an opportunity to preserve or enhance physiological integrity and optimize surgical recovery. Studies indicate a positive effect of prehabilitation on postoperative functional capacity and earlier return to daily activities and health related quality of life. Meaningful outcomes that reflect recovery from a patient's perspective and clinical outcome measures, as well as validating metrics, are necessary to establish whether prehabilitation diminish the risk of developing long-term disability in high-risk patients. IMPLICATIONS FOR NURSING PRACTICE Uro-oncology nurses are at the forefront in every ERAS program and vital in screening patients ahead of surgery for common risk factors, current impairments, and limitations that can compromise baseline functional capacity. The growing movement to standardize clinical implementation of prehabilitation, indicate there is a clear need for further investigation, optimization of a multimodal approach and an open discussion between health care providers from different areas of expertise who might best support and promote these initiatives.
Collapse
Affiliation(s)
| | - Susanne Vahr Lauridsen
- Department of Urology, Copenhagen University Hospital, Denmark and WHO-CC, Parker Institute Bispebjerg & Frederiksberg University Hospital, Frederiksberg, Denmark
| | - Celena Scheede-Bergdahl
- Department of Kinesiology and Physical Education, Department of Anesthesiology, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
16
|
Matulewicz RS, Makarov DV, Sherman SE, Birken SA, Bjurlin MA. Urologist-led smoking cessation: a way forward through implementation science. Transl Androl Urol 2021; 10:7-11. [PMID: 33532289 PMCID: PMC7844518 DOI: 10.21037/tau-20-1204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 09/11/2020] [Indexed: 12/29/2022] Open
Affiliation(s)
- Richard S. Matulewicz
- Department of Urology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
- Manhattan Campus, VA NY Harbor Health System, New York, NY, USA
| | - Danil V. Makarov
- Department of Urology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
- Manhattan Campus, VA NY Harbor Health System, New York, NY, USA
| | - Scott E. Sherman
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
- Manhattan Campus, VA NY Harbor Health System, New York, NY, USA
| | | | - Marc A. Bjurlin
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Urology, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
17
|
AUTHOR REPLY. Urology 2021; 147:184-185. [PMID: 33390202 DOI: 10.1016/j.urology.2020.05.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 05/14/2020] [Indexed: 11/20/2022]
|
18
|
Abstract
PURPOSE OF REVIEW This review summarizes the current knowledge regarding the relationship between smoking and bladder cancer (BCa), especially with respect to treatment outcomes for muscle and nonmuscle-invasive BCa (MIBC/NMIBC). RECENT FINDINGS PubMed/Medline databases were searched for recent reports investigating the association of smoking with BCa. Smoking is associated with an increased risk of recurrence in patients with NMIBC and may impair Bacillus Calmette-Guerin treatment efficacy. Moreover, smoking is associated with poor responses to neoadjuvant chemotherapy, poor survival outcomes and high complication rates in patients undergoing radical cystectomy. Smoking cessation mitigates these negative effects, especially. However, the amount of patient counselling provided regarding this important matter and patient knowledge regarding smoking and BCa risk are inadequate. Currently, the impact of secondhand smoke on BCa risk remains uncertain. SUMMARY Tobacco smoking is responsible for approximately half of BCa cases, and is associated with poor oncological outcomes for both NMIBC and MIBC. Despite smoking being a well known risk factor, counselling and knowledge in this area are insufficient. Appropriate smoking cessation interventions and patient information are required to improve patient health and optimize BCa survival.
Collapse
|
19
|
Fakhoury MQ, Ghorayeb AM, Houlihan MD, Powers RJ, Hurley S, Wille MA, Freeman VL, Kim K, Psutka SP, Vidal P, Hollowell CM. Predictive Risk Factors for Continued Smoking after the Diagnosis of a Genitourinary Malignancy. Urology 2020; 147:178-185. [PMID: 32663556 DOI: 10.1016/j.urology.2020.05.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 05/09/2020] [Accepted: 05/14/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine risk factors for continued smoking following a diagnosis of a genitourinary (GU) malignancy. Smoking is a well established risk factor in the development of cancers involving the GU tract. Unfortunately, a large percentage of patients continue to smoke or relapse after cancer diagnosis; by doing so, there is an increased risk of recurrence, poor survival rates, treatment complications, secondary primary cancers, and other chronic smoking related illnesses. MATERIALS AND METHODS Two hundred and five patients who presented to a Urologic Oncology clinic at a single tertiary treatment center were given smoking cessation counseling and pharmacotherapy, as well as a questionnaire which was used to identify smoking status, demographics, and behavioral/psychosocial characteristics. Patients were followed for a minimum of 1 year with a median length of follow up for 13 months. RESULTS 91% of patients enrolled in the study continued smoking at survey completion. After accounting for age, ethnicity, education and cigarettes consumed/day, 5 variables were independently associated with an increased risk of continued smoking: smoking 20 or more cigarettes per day, less than 2 prior quit attempts, anxiety and/or depression, fear of cancer recurrence, and home secondhand smoke exposure. CONCLUSION The role of the urologist is imperative for encouraging smoking cessation. While every patient should receive adequate counseling regarding smoking at the time of a GU malignancy diagnosis, identifying patients with the risk factors noted in this study and augmenting smoking cessation efforts may result in stronger efforts to quit and prevention of long-term complications.
Collapse
Affiliation(s)
- Mathew Q Fakhoury
- Division of Urology, Cook County Hospital, Cook County Health and Hospitals System, Chicago, IL
| | - Antoine M Ghorayeb
- Division of Urology, Cook County Hospital, Cook County Health and Hospitals System, Chicago, IL.
| | - Matthew D Houlihan
- Division of Urology, Cook County Hospital, Cook County Health and Hospitals System, Chicago, IL
| | - Ryan J Powers
- Division of Urology, Cook County Hospital, Cook County Health and Hospitals System, Chicago, IL
| | - Stephen Hurley
- Division of Urology, Cook County Hospital, Cook County Health and Hospitals System, Chicago, IL
| | - Mark A Wille
- Division of Urology, Cook County Hospital, Cook County Health and Hospitals System, Chicago, IL; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Vincent L Freeman
- School of Public Health, University of Illinois at Chicago, Chicago, IL
| | - Kyeezu Kim
- School of Public Health, University of Illinois at Chicago, Chicago, IL
| | - Sarah P Psutka
- Division of Urology, Cook County Hospital, Cook County Health and Hospitals System, Chicago, IL; Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Patricia Vidal
- Division of Urology, Cook County Hospital, Cook County Health and Hospitals System, Chicago, IL
| | - Courtney Mp Hollowell
- Division of Urology, Cook County Hospital, Cook County Health and Hospitals System, Chicago, IL
| |
Collapse
|
20
|
Sosnowski R, Kamecki H, Bjurlin MA, Przewoźniak K. The diagnosis of bladder cancer: are we missing a teachable moment for smoking cessation? Transl Androl Urol 2019; 8:S318-S321. [PMID: 31392157 DOI: 10.21037/tau.2019.05.15] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Roman Sosnowski
- Department of Urogenital Cancer, Oncology Center-M. Skłodowska-Curie Institute, Warsaw, Poland
| | - Hubert Kamecki
- Department of Urogenital Cancer, Oncology Center-M. Skłodowska-Curie Institute, Warsaw, Poland
| | - Marc A Bjurlin
- Department of Urology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Krzysztof Przewoźniak
- Department of Cancer Epidemiology and Prevention, Oncology Center-M. Skłodowska-Curie Institute, Warsaw, Poland
| |
Collapse
|
21
|
Second primary lung cancer in United States Cancer Survivors, 1992–2008. Cancer Causes Control 2019; 30:465-475. [DOI: 10.1007/s10552-019-01161-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 02/10/2019] [Indexed: 12/19/2022]
|
22
|
Fernández MI, Brausi M, Clark PE, Cookson MS, Grossman HB, Khochikar M, Kiemeney LA, Malavaud B, Sanchez-Salas R, Soloway MS, Svatek RS, Vikram R, Vrieling A, Kamat AM. Epidemiology, prevention, screening, diagnosis, and evaluation: update of the ICUD-SIU joint consultation on bladder cancer. World J Urol 2018; 37:3-13. [PMID: 30105454 DOI: 10.1007/s00345-018-2436-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 08/06/2018] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To update current recommendations on prevention, screening, diagnosis, and evaluation of bladder cancer (BC) based on a thorough assessment of the most recent literature on these topics. METHODS A non-systematic review was performed, including articles until June 2017. A variety of original articles, reviews, and editorials were selected according to their epidemiologic, demographic, and clinical relevance. Assessment of the level of evidence and grade of recommendations was performed according to the International Consultation on Urological Diseases grading system. RESULTS BC is the ninth most common cancer worldwide with 430,000 new cases in 2012. Currently, approximately 165,000 people die from the disease annually. Absolute incidence and prevalence of BC are expected to rise significantly during the next decades because of population ageing. Tobacco smoking is still the main risk factor, accounting for about 50% of cases. Smoking cessation is, therefore, the most relevant recommendation in terms of prevention, as the risk of developing BC drops almost 40% within 5 years of cessation. BC screening is not recommended for the general population. BC diagnosis remains mainly based on cystoscopy, but development of new endoscopic and imaging technologies may rapidly change the diagnosis algorithm. The same applies for local, regional, and distant staging modalities. CONCLUSIONS A thorough understanding of epidemiology, risk factors, early detection strategies, diagnosis, and evaluation is essential for correct, evidence-based management of BC patients. Recent developments in endoscopic techniques and imaging raise the hope for providing better risk-adopted approaches and thereby improving clinical outcomes.
Collapse
Affiliation(s)
- Mario I Fernández
- Department of Urology, Clínica Alemana, Santiago, Chile.,Faculty of Medicine, Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | | | - Peter E Clark
- Department of Urology, Atrium Health, Levine Cancer Institute, Charlotte, NC, USA
| | - Michael S Cookson
- Department of Urology, The University of Oklahoma Health Sciences Center & The Stephenson Cancer Center, Oklahoma City, OK, USA
| | - H Barton Grossman
- Department of Urology, Unit 1373, The University of Texas MD Anderson Cancer Center, 1155 Pressler, Houston, TX, 77030, USA
| | - Makarand Khochikar
- Department of Urology, Siddhi Vinayak Ganapati Cancer Hospital, Miraj, India
| | - Lambertus A Kiemeney
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bernard Malavaud
- Department of Urology, Toulouse Cancer Institute, Toulouse, France
| | | | - Mark S Soloway
- Department of Urology, Memorial Healthcare System, Miami, FL, USA
| | - Robert S Svatek
- Department of Urology, University of Texas Health, San Antonio, TX, USA
| | - Raghunandan Vikram
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alina Vrieling
- Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ashish M Kamat
- Department of Urology, Unit 1373, The University of Texas MD Anderson Cancer Center, 1155 Pressler, Houston, TX, 77030, USA.
| |
Collapse
|
23
|
Abstract
PURPOSE OF REVIEW To summarize the current knowledge about smoking carcinogenesis in bladder cancer (BCa), individual susceptibility and impact of smoking on incidence and outcomes of nonmuscle invasive BCa (NMIBC) and muscle-invasive BCa (MIBC). To assess the impact of smoking cessation on oncological outcomes. RECENT FINDINGS Smoking pattern, intensity, and duration are responsible for an increased risk of developing BCa and for worse tumor features at presentation. Tobacco consumption is associated with a higher risk of recurrence in NMIBC and with an impaired intravesical therapy efficacy. To date, the impact of smoking on oncological outcomes after radical surgery remains unclear. SUMMARY Smoking cessation decreases the risk of BCa and may also allow benefits on treatment outcomes. Nonetheless, the magnitude of the effect remains unclear and prospective series with the specific aim of weighing smoking cessation on outcomes are needed. Because even a 5-min counseling in the urology setting may be sufficient to significantly enhance smoking cessation rates, adequate knowledge of links between tobacco and BCa, from its molecular pathophysiology and its harms to benefits of cessation is paramount for urologists and for everyday clinical practice.
Collapse
|
24
|
Atala A. Re: E-Cigarette Smoke Damages DNA and Reduces Repair Activity in Mouse Lung, Heart, and Bladder as Well as in Human Lung and Bladder Cells. J Urol 2018; 200:701. [PMID: 30227585 DOI: 10.1016/j.juro.2018.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
25
|
van Osch FHM, Jochems SHJ, Reulen RC, Pirrie SJ, Nekeman D, Wesselius A, James ND, Wallace DMA, Cheng KK, van Schooten FJ, Bryan RT, Zeegers MP. The association between smoking cessation before and after diagnosis and non-muscle-invasive bladder cancer recurrence: a prospective cohort study. Cancer Causes Control 2018; 29:675-683. [PMID: 29846846 PMCID: PMC5999150 DOI: 10.1007/s10552-018-1046-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/28/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Smoking is a major risk factor for bladder cancer, but the relationship between smoking cessation after initial treatment and bladder cancer recurrence has been investigated less frequently and not prospectively yet. METHODS 722 non-muscle-invasive bladder cancer (NMIBC) patients (pTa, pT1, and CIS) from the prospective Bladder Cancer Prognosis Programme (BCPP) cohort, selected in the UK between 2005 and 2011, provided complete data on smoking behavior before and up to 5 years after diagnosis. The impact of smoking behavior on NMIBC recurrence was explored by multivariable Cox regression models investigating time-to-first NMIBC recurrence. RESULTS Over a median follow-up period of 4.21 years, 403 pathologically confirmed NMIBC recurrences occurred in 210 patients. Only 25 current smokers at diagnosis quit smoking (14%) during follow-up and smoking cessation after diagnosis did not decrease risk of recurrence compared to continuing smokers (p = 0.352). CONCLUSIONS Although quitting smoking after diagnosis might reduce the risk of recurrence based on retrospective evidence, this is not confirmed in this prospective study because the number of NMIBC patients quitting smoking before their first recurrence was too low. Nevertheless, this indicates an important role for urologists and other health care professionals in promoting smoking cessation in NMIBC.
Collapse
Affiliation(s)
- Frits H M van Osch
- Unit of Nutritional and Cancer Epidemiology, Chairgroup of Complex Genetics and Epidemiology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands.
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK.
| | - Sylvia H J Jochems
- Unit of Nutritional and Cancer Epidemiology, Chairgroup of Complex Genetics and Epidemiology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Raoul C Reulen
- Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
| | - Sarah J Pirrie
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Duncan Nekeman
- Unit of Nutritional and Cancer Epidemiology, Chairgroup of Complex Genetics and Epidemiology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Anke Wesselius
- Unit of Nutritional and Cancer Epidemiology, Chairgroup of Complex Genetics and Epidemiology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Nicholas D James
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- University Hospital Birmingham, NHS Foundation Trust, Birmingham, UK
| | - D Michael A Wallace
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- University Hospital Birmingham, NHS Foundation Trust, Birmingham, UK
| | - K K Cheng
- Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
| | - Frederik J van Schooten
- Department of Pharmacology and Toxicology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Richard T Bryan
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Maurice P Zeegers
- Unit of Nutritional and Cancer Epidemiology, Chairgroup of Complex Genetics and Epidemiology, School for Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
- Chairgroup of Complex Genetics and Epidemiology, Care and Public Health Research Institute (CAPRHI), Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
26
|
Kwan ML, Garren B, Nielsen ME, Tang L. Lifestyle and nutritional modifiable factors in the prevention and treatment of bladder cancer. Urol Oncol 2018; 37:380-386. [PMID: 29703514 DOI: 10.1016/j.urolonc.2018.03.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 02/16/2018] [Accepted: 03/27/2018] [Indexed: 12/13/2022]
Abstract
Bladder cancer is one of the top 5 most common cancers diagnosed in the U.S. It is also one of the most expensive cancers to treat through the life course given its high rate of recurrence. While cigarette smoking and occupational exposures have been firmly established as risk factors, it is less certain whether modifiable lifestyle factors such as diet and physical activity play roles in bladder cancer etiology and prognosis. This literature review based on a PubMed search summarizes the research to date on key dietary factors, types of physical activity, and smoking in relation to bladder cancer incidence, and discusses the potential public health implications for formalized smoking cessation programs among recently diagnosed patients. Overall, population-based research in bladder cancer is growing, and will be a key platform to inform patients diagnosed and living with bladder cancer, as well as their treating clinicians, how lifestyle changes can lead to the best outcomes possible.
Collapse
Affiliation(s)
- Marilyn L Kwan
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612.
| | - Brandon Garren
- Department of Urology, University of North Carolina, Chapel Hill, NC 27599
| | - Matthew E Nielsen
- Department of Urology, University of North Carolina, Chapel Hill, NC 27599; Departments of Epidemiology and Health Policy & Management, University of North Carolina, Chapel Hill, NC 27599
| | - Li Tang
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Elm and Carlton Streets, Buffalo, NY 14263
| |
Collapse
|
27
|
Knowledge of smoking as a risk factor for disease among urology clinic patients in Australia. World J Urol 2018; 36:1219-1224. [PMID: 29589133 DOI: 10.1007/s00345-018-2276-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/20/2018] [Indexed: 10/17/2022] Open
Abstract
INTRODUCTION Smoking remains a common habit among the general population. Despite the well-established risks of smoking, relatively few studies have been undertaken to assess the understanding of these risks among the general population. We intended to assess the understanding of smoking as a risk factor for various conditions in a urology outpatient cohort to assess the level of knowledge as well as particular strengths and weaknesses they possess. METHODS A four-page questionnaire was distributed among urology outpatients over a 5 month period. The questionnaire captured information regarding the knowledge of smoking as a risk factor for various urological and non-urological conditions. Results were collated and stratified according to patient's cancer history as well as smoking status. RESULTS A total of 112 participants were included in our analytical sample. Our study demonstrated a deficiency in knowledge regarding smoking and urological conditions. When ranked by level of knowledge, four of the bottom five conditions were urological in nature. Furthermore, we found that patients with a personal cancer history demonstrated generally poorer knowledge of smoking as a risk factor compared to patients without a cancer history. Conversely, smokers themselves demonstrated a greater understanding of risks compared to non-smokers. CONCLUSIONS Our study suggests there is much work to be done in the education of patients on the risks of smoking from a urological point of view. We believe more initiative needs to be taken by the specialists treating such patients to achieve an improved level of knowledge.
Collapse
|
28
|
Safavy S, Kilday PS, Slezak JM, Abdelsayed GA, Harrison TN, Jacobsen SJ, Chien GW. Effect of a Smoking Cessation Program on Sexual Function Recovery Following Robotic Prostatectomy at Kaiser Permanente Southern California. Perm J 2018; 21:16-138. [PMID: 28488986 DOI: 10.7812/tpp/16-138] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The association between cigarette smoking and erectile dysfunction has been well established. Studies demonstrate improvements in erectile rigidity and tumescence as a result of smoking cessation. Radical prostatectomy is also associated with worsening of erectile function secondary to damage to the neurovascular bundles. To our knowledge, no previous studies have examined the relationship between smoking cessation after prostate cancer diagnosis and its effect on sexual function following robotic prostatectomy. We sought to demonstrate the utility of a smoking cessation program among patients with prostate cancer who planned to undergo robotic prostatectomy at Kaiser Permanente Southern California. METHODS All patients who underwent robotic prostatectomy between March 2011 and April 2013 with known smoking status were included, and were followed-up through November 2014. All smokers were offered the smoking cessation program, which included wellness coaching, tobacco cessation classes, and pharmacotherapy. Patients completed the Expanded Prostate Cancer Index Composite-26 (EPIC-26) health-related quality-of-life (HR-QOL) survey at baseline and postoperatively at 1, 3, 6, 12, 18, and 24 months. There were 2 groups based on smoking status: Continued smoking vs quitting group. Patient's age, Charlson Comorbidity Score, body mass index, educational level, median household income, family history of prostate cancer, race/ethnicity, language, nerve-sparing status, and preoperative/postoperative clinicopathology and EPIC-26 HR-QOL scores were examined. A linear regression model was used to predict sexual function recovery. RESULTS A total of 139 patients identified as smokers underwent the smoking cessation program and completed the EPIC-26 surveys. Fifty-six patients quit smoking, whereas 83 remained smokers at last follow-up. All demographics and clinicopathology were matched between the 2 cohorts. Smoking cessation, along with bilateral nerve-sparing status, were the only 2 modifiable factors associated with improved sexual function after prostatectomy (6.57 points, p = 0.0226 and 8.97 points, p = 0.0485, respectively). CONCLUSION In the setting of robotic prostatectomy, perioperative smoking cessation is associated with a significant improvement in long-term sexual functional outcome when other factors are adjusted.
Collapse
Affiliation(s)
- Seena Safavy
- Urologist at the Los Angeles Medical Center in CA.
| | | | - Jeff M Slezak
- Research Manager in Biostatistics for the Southern California Permanente Medical Group in Pasadena.
| | | | - Teresa N Harrison
- Research Manager in Biostatistics for the Southern California Permanente Medical Group in Pasadena.
| | - Steven J Jacobsen
- Director of Research in the Department of Research and Evaluation for Kaiser Permanente Southern California in Pasadena.
| | - Gary W Chien
- Director of the Urology Residency Program at the Los Angeles Medical Center in CA.
| |
Collapse
|
29
|
May M, Fritsche HM, Gilfrich C, Dombrowski M, Maurer O, Spachmann P, Kumar MG, Bjurlin M, Burger M, Brookman-May S. What do patients with urothelial cancer know about the association of their tumor disease with smoking habits? Results of a German survey study. Investig Clin Urol 2018. [PMID: 29520384 PMCID: PMC5840123 DOI: 10.4111/icu.2018.59.2.91] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Purpose Smoking represents a primary risk factor for the development of urothelial carcinoma (UC) and a relevant factor impacting UC-specific prognosis. Data on the accordant knowledge of UC-patients in this regard and the significance of physicians in the education of UC-patients is limited. Materials and Methods Eighty-eight UC-patients were enrolled in a 23-items-survey-study aimed to analyse patient knowledge and awareness of their tumor disease with smoking along with physician smoking cessation counselling. Results The median age of the study patients was 69 years; 26.1% (n=23), 46.6% (n=41), and 27.3% (n=24), respectively, were non-smokers, previous, and active smokers. Exactly 50% of active smokers reported a previous communication with a physician about the association of smoking and their tumor disease; however, only 25.0% were aware of smoking as main risk factor for UC development. Merely 33% of the active smokers had been prompted directly by their physicians to quit smoking. About 42% of active smokers had received the information that maintaining smoking could result in a tumor-specific impairment of their prognosis. Closely 29% of active and about 5% of previous smokers (during the time-period of active smoking) had been offered support from physicians for smoking cessation. No association was found between smoking anamnesis (p=0.574) and pack-years (p=0.912), respectively, and tumor stage of UC. Conclusions The results of this study suggest that the medical conversation of physicians with UC-patients about the adverse significance of smoking is limited. Implementation of structured educational programs for smoking cessation may be an opportunity to further enhance comprehensive cancer care.
Collapse
Affiliation(s)
- Matthias May
- Department of Urology, St. Elisabeth Hospital Straubing, Straubing, Germany
| | - Hans-Martin Fritsche
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Christian Gilfrich
- Department of Urology, St. Elisabeth Hospital Straubing, Straubing, Germany
| | - Mirja Dombrowski
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Odilo Maurer
- Department of Urology, St. Elisabeth Hospital Straubing, Straubing, Germany
| | - Philipp Spachmann
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Manju Ganesh Kumar
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Marc Bjurlin
- Department of Urology, New York University Langone Hospital, New York University School of Medicine, New York, NY, USA
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Sabine Brookman-May
- Department of Urology, Ludwig-Maximilians University (LMU), Munich, Germany.,Department of Urology, Janssen Pharma Research and Development, Los Angeles, CA, USA
| |
Collapse
|
30
|
Outcomes for a Public Hospital Tobacco Cessation Program: The Cook County Health and Hospitals System Experience. J Community Health 2018; 41:1130-1139. [PMID: 27393143 DOI: 10.1007/s10900-016-0215-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this study is to determine the rate and predictors of sustained smoking cessation for a cohort of smokers exposed to a guideline-based health education program delivered during routine clinical care at an urban public hospital. This is a retrospective analysis of 755 public hospital system patients who had at least two health educator contacts embedded in routine clinical care, with the latter contact 12-18 months after the baseline. The education occurred during visits to primary care, specialty clinics, urgent/episodic care, or during hospitalization. The assessment of smoking status is determined by the health educators as part of their routine assessment and recorded in the program's database. The primary outcomes are self-reported 12-month sustained smoking cessation at the 12-18 month contact and predictors of cessation. The cohort is predominantly minority smokers (African American 69 % and Latino 15 %) and uninsured (70 %) or on Medicaid (13 %). The sustained cessation rate was 9.3 %. Latino ethnicity, smoking 1-9 cigarettes/day at baseline, reporting smoke-free home, and additional educator contact in the year after the baseline were independent predictors of sustained cessation in the multivariate analysis. Smokers with multiple risks for poor cessation outcomes exposed to a guideline-based program of health education during routine healthcare encounters had sustained smoking cessation rates that compare favorably with published National Health Interview Study population cessation rates. An additional educator contact after the baseline was a predictor of cessation. The findings support development of cessation programs in which health educators are integrated into clinical care settings.
Collapse
|
31
|
Lauridsen SV, Thomsen T, Kaldan G, Lydom LN, Tønnesen H. Smoking and alcohol cessation intervention in relation to radical cystectomy: a qualitative study of cancer patients' experiences. BMC Cancer 2017; 17:793. [PMID: 29178899 PMCID: PMC5702236 DOI: 10.1186/s12885-017-3792-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/16/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Despite smoking and risky alcohol drinking being modifiable risk factors for cancer as well as postoperative complications, perioperative cessation counselling is often ignored. Little is known about how cancer patients experience smoking and alcohol interventions in relation to surgery. Therefore the aim of this study was to explore how bladder cancer patients experience a perioperative smoking and alcohol cessation intervention in relation to radical cystectomy. METHODS A qualitative study was conducted in two urology out-patient clinics. We conducted semi-structured in-depth interviews with 11 purposively sampled persons who had received the smoking and alcohol cessation intervention. The analysis followed the steps contained in the thematic network analysis. RESULTS Two global themes emerged: "smoking and alcohol cessation was experienced as an integral part of bladder cancer surgery" and "returning to everyday life was a barrier for continued smoking cessation/alcohol reduction". Participants described that during hospitalization their focus shifted to the operation and they did not experience craving to smoke or drink alcohol. Concurrent with improved well-being or experiencing stressful situations, the risk of relapse increased when returning to everyday life. CONCLUSIONS The smoking and alcohol cessation intervention was well received by the participants. Cancer surgery served as a kind of refuge and was a useful cue for motivating patients to quit smoking and to reconsider the consequences of risky drinking. These results adds to the sparse evidence of what supports smoking and alcohol cessation in relation to bladder cancer patients undergoing major surgery and point to the need to educate healthcare professionals in offering smoking and alcohol cessation interventions in hospitals. The study also provides knowledge about the intervention in the STOP-OP study and will help guide the design of future smoking and alcohol cessation studies aimed at cancer patients undergoing surgery.
Collapse
Affiliation(s)
- Susanne Vahr Lauridsen
- Department of Urology 2112, Inge Lehmanns Vej 7, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Thordis Thomsen
- Abdominal Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- University of Copenhagen, Health & Medical Sciences, Copenhagen, Denmark
| | - Gudrun Kaldan
- Abdominal Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Line Noes Lydom
- Department of Urology 2112, Inge Lehmanns Vej 7, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Hanne Tønnesen
- Clinical Health Promotion Centre, Bispebjerg & Frederiksberg Hospital, Copenhagen University Hospitals, Copenhagen, Denmark
- Clinical Health Promotion Centre, Health Sciences, Lund University, Lund, Sweden
- Health Science, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
32
|
Gottlieb J, Higley C, Sosnowski R, Bjurlin MA. Smoking-related genitourinary cancers: A global call to action in smoking cessation. Rev Urol 2017; 18:194-204. [PMID: 28127261 DOI: 10.3909/riu0729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Smoking is a known modifiable risk factor in the development of genitourinary malignancies. Although the association has long been supported by numerous research studies, the impact of smoking cessation on the decreased risk of genitourinary malignancies is less well studied. PubMed databases were searched using the terms smoking, smoking cessation, bladder cancer, kidney cancer, prostate cancer, penile cancer, testicular cancer, their synonyms, and also targeted manual searches to perform a literature review in order to summarize the benefits of cessation on disease progression and patient outcomes including survival and morbidities. Our review yielded substantial evidence highlighting the improved outcomes observed in those diagnosed with bladder, renal, and prostate cancers. The risk of bladder cancer is reduced by up to 60% in those who were able to quit for 25 years and the risk of kidney malignancy was reduced by 50% in those who abstained from smoking for 30 years. A similar trend of reduced risk was observed for prostate cancer with those who quit for more than 10 years, having prostate cancer mortality risks similar to those that never smoked. Although the data were encouraging for bladder, renal, and prostate malignancies, there are comparatively limited data quantifying the benefits of smoking cessation for penile and testicular cancers, highlighting an opportunity for further study. The role of urologists and their impact on their patients' likelihood to quit smoking shows more than half of urologists never discuss smoking cessation upon diagnosis of a malignancy. Most urologists said they did not provide cessation counseling because they do not believe it would alter their patients' disease progression. Studies show urologists have more influence at changing their patients' smoking behaviors than their primary care physicians. The diagnosis of cancer may lead to a teachable moment resulting in increased smoking quit rates. Furthermore, implementing a brief 5-minute clinic counseling session increases quit attempts and quit rates. Diagnosis of genitourinary cancers and the following appointments for treatment provide a unique opportunity for urologists to intervene and affect the progression and outcome of disease.
Collapse
Affiliation(s)
- Josh Gottlieb
- New York Institute of Technology College of Osteopathic Medicine Old Westbury, NY
| | - Cory Higley
- New York Institute of Technology College of Osteopathic Medicine Old Westbury, NY
| | - Roman Sosnowski
- Department of Uro-oncology, M. Sklodowska-Curie Memorial Cancer Center and Institute of Oncology Warsaw, Poland
| | - Marc A Bjurlin
- Division of Urology, Department of Surgery, NYU Lutheran Medical Center, NYU School of Medicine, NYU Langone Health System New York, NY
| |
Collapse
|
33
|
Sosnowski R, Bjurlin MA, Verze P, De Nunzio C, Shariat SF, Brausi M, Donin NM. Role of cigarette smoking in urological malignancies and clinical interventions for smoking cessation. Cent European J Urol 2016; 69:366-369. [PMID: 28127452 PMCID: PMC5260458 DOI: 10.5173/ceju.2016.883] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/11/2016] [Accepted: 10/05/2016] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Cigarette smoking is the single greatest preventable cause of disease and death. Our literature review highlights the increased risk of cigarette smoking and kidney cancer, bladder cancer and prostate cancer. MATERIAL AND METHODS Smoking cessation improves outcomes at all stages of these disease processes, where patients who quit for 10-20 years appear to obtain a similar risk as those who have never smoked, even after diagnosis of disease. RESULTS Urologists, however, very seldom provide smoking cessation assistance. By applying brief smoking cessation intervention techniques, physicians' posses an effective means of providing quitting advice. CONCLUSIONS Patients who receive smoking cessation advice from their urologist are 2.3 times more likely to attempt to quit. Urologists are well-positioned to screen, counsel, and promote cessation at regular intervals, which may improve quit rates, and ultimately improve our patients' outcomes.
Collapse
Affiliation(s)
- Roman Sosnowski
- Department of Urooncology, Maria Skłodowska-Curie Memorial Cancer Hospital, Warsaw, Poland
| | - Marc A. Bjurlin
- Division of Urology, Department of Surgery, NYU Lutheran Medical Center, NYU Langone Health System, New York, New York
| | - Paolo Verze
- Department of Urology, University Federico II of Naples, Naples, Italy
| | - Cosimo De Nunzio
- Department of Urology, Ospedale Sant’Andrea, University ‘La Sapienza’, Roma, Italy
| | - Shahrokh F. Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University Vienna, General Hospital, Vienna, Austria
| | - Maurizio Brausi
- Department of Urology, Ausl Modena, B. Ramazzini Hospital, Carpi-Modena, Italy
| | - Nicholas M. Donin
- Department of Urology, UCLA Institute of Urologic Oncology, Los Angeles, California, USA
| |
Collapse
|
34
|
Sosnowski R, Verze P, De Nunzio C, Bjurlin MA. Re: Marcus G. Cumberbatch, Matteo Rota, James W.F. Catto, Carlo La Vecchia. The Role of Tobacco Smoke in Bladder and Kidney Carcinogenesis: A Comparison of Exposures and Meta-analysis of Incidence and Mortality Risks. Eur Urol 2016;70:458-66: Smoking Cessation and Urology: A New Domain for Prevention and Treatment. Eur Urol 2016; 70:e102-e103. [PMID: 26456679 DOI: 10.1016/j.eururo.2015.09.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 09/23/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Roman Sosnowski
- Department of Uro-oncology, M. Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland.
| | - Paolo Verze
- Department of Urology, University Federico II of Naples, Naples, Italy
| | - Cosimo De Nunzio
- Department of Urology, Ospedale Sant'Andrea, University La Sapienza, Rome, Italy
| | - Marc A Bjurlin
- Division of Urology, Department of Surgery, SBH Health System, Bronx, NY, USA
| |
Collapse
|
35
|
Méndez-Rubio S, Salinas-Casado J, Esteban-Fuertes M, Méndez-Cea B, Sanz-de-Burgoa V, Cozar-Olmo JM. Urological disease and tobacco. A review for raising the awareness of urologists. Actas Urol Esp 2016; 40:424-33. [PMID: 26920096 DOI: 10.1016/j.acuro.2016.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/17/2016] [Accepted: 01/18/2016] [Indexed: 11/28/2022]
Abstract
CONTEXT Smoking is the leading cause of preventable death in our community. Its relationship with urological disease is well documented. OBJECTIVE To present an updated review on the relationship between urological disease and tobacco consumption and the importance of involving urologists in smoking prevention. ACQUISITION AND SYNTHESIS OF EVIDENCE We conducted a review of current literature, primarily by searching PubMed and using as the main base the report on the consequences of smoking on health performed by the Surgeon General. CONCLUSION Urologists play an essential role in informing patients of the relationship between smoking and urological disease. It is the duty of every urologist to play a more active role in educating patients and promoting smoking cessation.
Collapse
Affiliation(s)
- S Méndez-Rubio
- Servicio de Urología, Hospital Universitario Sanitas La Moraleja, Madrid, España.
| | - J Salinas-Casado
- Servicio de Urología, Hospital Clínico San Carlos, Madrid, España
| | - M Esteban-Fuertes
- Servicio de Urología, Hospital Nacional de Parapléjicos, Toledo, España
| | - B Méndez-Cea
- Facultad de Biología, Universidad Complutense de Madrid, Madrid, España
| | | | - J M Cozar-Olmo
- Servicio de Urología, Hospital Universitario Virgen de las Nieves, Granada, España
| |
Collapse
|
36
|
Cózar Olmo JM, Méndez Rubio S. Towards greater involvement of the urologist in smoking prevention. Actas Urol Esp 2015; 39:597-8. [PMID: 26233480 DOI: 10.1016/j.acuro.2015.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 06/24/2015] [Accepted: 06/29/2015] [Indexed: 11/25/2022]
Affiliation(s)
- J M Cózar Olmo
- Servicio de Urología, Hospital Universitario Virgen de las Nieves, Granada, España
| | - S Méndez Rubio
- Servicio de Urología, Hospital Universitario Sanitas La Moraleja, Madrid, España.
| |
Collapse
|
37
|
Muller J, Grosclaude P, Lapôtre-Ledoux B, Woronoff AS, Guizard AV, Bara S, Colonna M, Troussard X, Bouvier V, Trétarre B, Velten M, Jégu J. Trends in the risk of second primary cancer among bladder cancer survivors: a population-based cohort of 10 047 patients. BJU Int 2015; 118:53-9. [DOI: 10.1111/bju.13351] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Joris Muller
- Bas-Rhin Cancer Registry; EA 3430, FMTS; University of Strasbourg; Strasbourg France
- Department of Public Health; University Hospital of Strasbourg; Strasbourg France
| | - Pascale Grosclaude
- Tarn Cancer Registry; Albi France
- Francim: Réseau français des registres des cancers; Toulouse France
| | - Bénédicte Lapôtre-Ledoux
- Francim: Réseau français des registres des cancers; Toulouse France
- Somme Cancer Registry; Department of Hygiene and Public Health; University Hospital of Amiens; Amiens France
| | - Anne-Sophie Woronoff
- Francim: Réseau français des registres des cancers; Toulouse France
- Doubs and Belfort Territory Cancer Registry; University Hospital of Besançon; Besançon France
| | - Anne-Valérie Guizard
- Francim: Réseau français des registres des cancers; Toulouse France
- Calvados General Cancer Registry, Cancers & Préventions; U 1086 Inserm; François Baclesse Centre; Caen France
| | - Simona Bara
- Francim: Réseau français des registres des cancers; Toulouse France
- Manche Cancer Registry; Cotentin Hospital; Cherbourg-Octeville France
| | - Marc Colonna
- Francim: Réseau français des registres des cancers; Toulouse France
- Isère Cancer Registry; University Hospital of Grenoble; Grenoble France
| | - Xavier Troussard
- Francim: Réseau français des registres des cancers; Toulouse France
- Basse-Normandie Haematological Malignancies Cancer Registry; University Hospital of Caen; Caen France
| | - Véronique Bouvier
- Francim: Réseau français des registres des cancers; Toulouse France
- Calvados Digestive Cancer Registry Cancers & Préventions; U 1086 Inserm; François Baclesse Centre; Caen France
| | - Brigitte Trétarre
- Francim: Réseau français des registres des cancers; Toulouse France
- Hérault Cancer Registry; Research Center; Montpellier France
| | - Michel Velten
- Bas-Rhin Cancer Registry; EA 3430, FMTS; University of Strasbourg; Strasbourg France
- Department of Public Health; University Hospital of Strasbourg; Strasbourg France
- Francim: Réseau français des registres des cancers; Toulouse France
- Department of Epidemiology and Biostatistics; Paul Strauss Center; Strasbourg France
| | - Jérémie Jégu
- Bas-Rhin Cancer Registry; EA 3430, FMTS; University of Strasbourg; Strasbourg France
- Department of Public Health; University Hospital of Strasbourg; Strasbourg France
- Francim: Réseau français des registres des cancers; Toulouse France
| |
Collapse
|
38
|
Sosnowski R, Przewoźniak K. The role of the urologist in smoking cessation: why is it important? Urol Oncol 2014; 33:30-39. [PMID: 25154777 DOI: 10.1016/j.urolonc.2014.07.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 07/20/2014] [Accepted: 07/21/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Tobacco use is the most preventable cause of death in the world today. Smoking is a well-known risk factor for various cancers, including urothelial carcinoma, and bladder cancer (BCa) is a leading global cause of cancer mortality in men. OBJECTIVE To review the epidemiology of BCa as a tobacco-related disease, the association between smoking and BCa risk, and the potential smoking cessation interventions that urologists can perform in their medical practice. METHODS A search of recent literature was conducted using the MEDLINE database and the Internet, as well as resources from well-known health, cancer, and tobacco control organizations. RESULTS Smoking is well described as a risk factor of BCa. The risk correlates with the number of cigarettes smoked daily and the duration of smoking. Moreover, smoking worsens BCa treatment outcomes and prognosis. However, smoking cessation substantially prolongs life at every stage, and brief medical interventions can be performed by urologists that can result in the patient ceasing to smoke. Patient education is critical, especially if the patient is unaware that smoking increases the risk of BCa. CONCLUSION Urologists may play an essential role in helping their patients cease smoking, subsequently decreasing the smoking-related risk of BCa. Their cessation efforts should be focused on brief interventions and collaboration with specialized smoking cessation resources.
Collapse
Affiliation(s)
- Roman Sosnowski
- Department of Urooncology, the Maria Skłodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland.
| | - Krzysztof Przewoźniak
- Department of Cancer Epidemiology and Prevention, the Maria Skłodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland
| |
Collapse
|
39
|
Choi NG, DiNitto DM. Role of New Diagnosis, Social Isolation, and Depression in Older Adults’ Smoking Cessation. THE GERONTOLOGIST 2014; 55:793-801. [DOI: 10.1093/geront/gnu049] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 04/14/2014] [Indexed: 11/13/2022] Open
|
40
|
Skeldon SC, Larry Goldenberg S. Bladder cancer: a portal into men's health. Urol Oncol 2014; 33:40-44. [PMID: 24745663 DOI: 10.1016/j.urolonc.2013.12.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 12/13/2013] [Accepted: 12/15/2013] [Indexed: 01/08/2023]
Abstract
Bladder cancer is the fourth most common cancer among men in the United States, with a 3-fold higher incidence than women. Globally, tobacco smoking remains significantly more common in men, contributing to half of all cases of bladder cancer. To prevent bladder cancer, urologists should promote smoking cessation to patients presenting at earlier ages with concerns such as sexual dysfunction, infertility, pelvic pain, or vasectomy. Bladder cancer also provides an entry point for men into the healthcare system, at which time, urologists can discuss and coordinate attention to other male health issues such as cardiovascular illness, depression, or addiction. By assuming the role of men's health physicians, urologists can have a significant benefit on men's urologic and overall health by targeting risk factors and behaviors.
Collapse
Affiliation(s)
- Sean C Skeldon
- Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - S Larry Goldenberg
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
| |
Collapse
|