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Smoking During Lung Cancer Treatment

This study concludes that patients with small-cell lung cancer (SCLC) who continue to smoke during treatment are more likely to die within five years than patients who quit smoking before treatment begins. Small-cell lung cancer is almost always caused by smoking, and it is difficult to treat even when it has not spread. The 215 patients in this study had limited stage cancer (confined to one lung and nearby lymph nodes). They were treated with chemo-therapy and radiation to the chest at the same time.

Smoking status was recorded for 186 patients in the study. Of this group, 79 smoked during treatment and 107 had quit smoking before treatment. Based on factors such as age, sex, and overall health, there were no significant differences between the two groups to account for the difference in outcomes.

Two years after therapy:

Twenty-eight percent (28%) of non-smokers were still living, compared with 16% of smokers. At five years, nearly 9% of non-smokers were still alive, compared with 4% of smokers.

Thirty-two percent (32%) of non-smokers and 18% of smokers remained free of disease. At five years, 18% of non-smokers were disease free, compared with 7% of smokers.

Smokers were just as likely as non-smokers to stop treatment because of side effects. But smokers who had to stop treatment to recover from side effects had poorer overall survival compared to other patients. (Abstract #1176)

What does this mean for patients? Though quitting smoking is difficult, this study shows that quitting smoking can have benefits at any stage of lung cancer.

"The evidence shows that smokers tolerated the treatment as well as non-smokers did," said study leader Greg Videtic, MD, of the Dana-Farber Cancer Institute in Boston. "Even so, the lower survival rates of smokers suggest that smoking itself may reduce the effectiveness of the therapy." "I tell my patients to stop smoking so they can gain all the possible benefits of treatment," said Dr. Videtic.