By Craig Earle
Craig Earle is a GTA-based oncologist and Vice-President, Cancer Control, at the Canadian Partnership Against Cancer.
The start of the new year means many will be looking to fulfill resolutions, a major one being quitting smoking. While provincial and territorial governments continue to push for all people to give up cigarette smoking through the Endgame Tobacco initiative, one group who often get over-looked are those living with cancer.
One in 5 Canadians with cancer are smokers. A diagnosis of cancer is sometimes a “wake up call” that prompts a patient to throw away their cigarettes, but for many it’s a particularly difficult time to contemplate quitting because of the stress and anxiety of their new situation. This is something I can understand. Cancer and its treatment have significant physical, emotional and psychosocial effects and smoking can seem to help someone cope during such a difficult time.
Most of my patients who continue to smoke do not think it plays a major role in their treatment or outcomes. I often hear, “I already have cancer, what does it matter now if I smoke?” This is particularly apparent in people who develop a cancer perceived to be unrelated to smoking. Someone who develops lung cancer may be more likely to at least consider quitting than someone who develops, say, breast cancer, as they may not see the connection.
For many years, we cancer care providers felt the same way. We were not really aware of the impact smoking could have on cancer treatment. We thought smoking was a minor thing in the context of their larger health problem. But it turns out, it’s not.
Accumulating evidence now clearly shows that quitting smoking can make cancer treatment more effective. Plain and simple. This includes all types of cancer treatment, for all types of cancer.
Patients who smoke are more likely to have infections or problems with wound healing after cancer surgery. Smoking reduces oxygen levels in the blood, which makes radiotherapy less effective. And for chemotherapy, chemicals in cigarette smoke can speed up the metab- olism of cancer drugs, leading to lower effective doses.
No matter the treatment, strong evidence shows quitting smoking will help improve your outcomes on par with the effects of many new cancer treatments. Quitting smoking also low- ers the chance of the cancer returning or another type of cancer developing, in addition to improving other more general aspects of your health.
With this recent evidence, the cancer system is starting to take notice. Many cancer care providers are now routinely having conversations with patients about quitting smoking and directing them to tobacco cessation supports. And these resources will soon be more convenient for all cancer patients.
The Canadian Partnership Against Cancer is providing almost $2 million to support the implementation of tobacco cessation programs in every jurisdiction in this country. The goal is to ensure every person with cancer who wishes to quit smoking has the support and resources to do so. Newfoundland and Labrador was the first jurisdiction to sign a contract with the Partnership on this initiative. That province is providing free nicotine replacement therapy to all people newly diagnosed with cancer, as well as ongoing counselling to further assist them.
If you are a patient with cancer and looking to quit, you’re doing the right thing. I understand how challenging the addiction is. I will say that based on the available evidence, I would advise that in order to get the full benefit, you should quit smoking at least two weeks before starting cancer treatment. The sooner, the better.
For others who have been diagnosed with cancer and haven’t yet decided to quit, please know that no matter what type of cancer you have, quitting is one of the most important things you can do for your health. It will increase the effectiveness of your treatment, increase your chances of survival, and improve your quality of life.
If you are a cancer patient and still smoking, there are many resources out there for you and many organizations who can help you take the first step.