Lung Cancer and Smoking Cessation

[gpawelski]

Since a substantial number of patients presenting with lung cancer either smoked in the recent past or continue to do so, it is important to make sure that the patient stops smoking as soon as possible to improve their treatment outcome. The emphasis should be on improvement of treatment outcome and future health improvement.

There are guidelines regarding smoking cessation techniques that have resulted from reviews of the world's literature and are very well accepted throughout the medical and psychological fields. However, the biggest problem remains in having healthcare providers implement them routinely. Most have emphasized the role of the primary healthcare provider in providing smoking cessaton advice to patients, whereas the specialists, such as medical oncologists, radiation oncologists, thoracic surgeons or pulmonary care specialists should be dealing with the health problems resulting from the smoking as the patient faces imminent interventions such as radiation therapy, chemotherapy or surgery.

Since ongoing smoking may significantly affect the outcome of subsequent surgery or therapy and negatively impact long-term survival, it is now the specialists' turn to provide the urgent smoking cessation treatment. Besides providing evaluation and management services, making referrels for diagnostic testing, radiation therapy, surgery and other procedures as necessary, and offer any other support needed to reduce patient morbidity and extend patient survival, I certainly hope they add smoking cessation guidance and support.

No pharmaceutical trial ever followed whether patients smoked during their clinical trials, despite dosing themselves daily with cigarettes with thousands of chemicals in them. The addition of nicotine inhibits the ability of a chemo drug (like etoposide) to induce apoptosis by 61%. If a drug like nicotine, which occurs in the highest concentration of any drug in a cigarette, inhibits the ability of a major chemotherapy drug by 61%, a medical oncologist should care if it was being ingested during treatment.

www.treatobacco.net is an evidence-based site containing information in 11 languages on tobacco dependence treatment relative to efficacy, safety, demographics and health effects, health economics, and policy.

www.cdc.gov/tobacco/ is a site to let you know everything you wanted to know about tobacco at the CDC.

www.guideline.gov/summary/summary.aspx? ... 8&nbr=2184 is the National Guideline Clearinghouse web site for smoking cessaton.

[Jyoung20]

Are you a survivor or caregiver? I am interested because you seem to be very educated in the area of lung cancer and smoking. I am curious to know your background.

GOD BLESS!!

Jamie

[gpawelski]

I was a caregiver to the "love of my life." I had a relative who had carcinomatous meningitis at the very same time my wife had it in 1999. His was from lung cancer, my wife's was from ovarian cancer. That is another very serious issue if one is not properly informed of cancer diagnosis and treatments.

I do keep in contact with the thoracic surgical oncologist who operated on my wife's first recurrence in 1996. She is no longer at that NCI-designated institution, and is now head of the Tobacco and Cancer Group of the International Agency for Research on Cancer.

In our follow-up appointments, she would talk about the sorrow she had in operating on all these chest patients, and then they would not live that long. She is one of the finest surgeons but she got to operate on many patients that were advanced in there disease. I guess that goes with the territory. If you're the best, they want to give you the worst patients.

She decided to go on the other side of things and do something about what predominately caused this disease, rather than cleaning up its' mess. She is doing just that. I wish her all the power in the world to help people quit smoking. I totally support her crusade to get people to quit smoking.

The number of people who do not quit smoking "during cancer treatment" was extremely surprising. The statistic on etopside was alarming. Yes. It is up to the oncologist, especially now being paid under the new Medicare bill for support needed to reduce patient morbidity and extend patient survival, to include smoking cessation guidance and support. Thanks for asking. My profile lists the web site for my wife's story.

[karen335]

Thank you for sharing GD.

Karen

[gpawelski]

Since a substantial number of patients presenting to a cardiothoracic surgery clinic either smoked in the recent past or continue to do so, it is important to make sure that patients stop smoking as soon as possible to improve their treatment outcome. The emphasis should be on improvement of treatment outcome and future health improvement. Reinforcing the guilt feelings the patient may already have is counterproductive, and is a significant concern of patient and patient advocacy groups at the present time.

http://www.ctsnet.org/sections/clinical ... ch-25.html

[janwalkerimages]

I agree that adding to the "guilt" is not what is needed. Compassion, understanding, support, education, and readily available information is what is needed - not "guilt". There are enough stressful emotions to go around during this battle without compounding those emotions.

My husband, Bill, and myself went to Mayo this past March for confirmation of his diagnosis and surgery. Mayo advised that chemo is sort of like getting gasoline in your car - it doesn't matter where you fill up provided that they develop the protocol. They recommended Cisplatin/Navelbine. We come back to Missouri and the onocologist here recommends Carbo/Tax combination and tells us to decide by the following Monday. We search & search for comparison study results concerning side effects vs. efficacy. We had a devil of a time finding published results in order to make this life and death decision.

[aurora06]

Treatment outcome can be greatly improved with EARLY DETECTION!!!

[RandyW]

There Is a simple blood test being researched in order to provide early detection to replace costly scans and x rays. I have posted in the grieving Forumand it is an alert for New meds and clinical trials. I am the Moderator of that Forumand understand your thinking about this. Whenever I hear something new I will post in New Meds and Trials Forum. Thanks for the Input about the concern.