El Informe 2014 del Cirujano General de los EEUU es muy impactante. Fumar aumenta el riesgo de muerte de los pacientes con cáncer, aumenta el riesgo de un segundo cáncer y también hay una fuerte evidencia que empeora los efectos adversos de los tratamientos.
Helping Cancer Patients Quit Smoking Should Be a Standard of Care
Graham W. Warren, MD, PhD and K. Michael Cummings, PhD, MPH
Published Online: Monday, March 30, 2015
Overwhelming evidence presented in the 2014 Surgeon General’s Report resulted in the conclusion that smoking causes adverse outcomes in patients with cancer.1 Current smoking increases risk for overall mortality by a median of 51% and increases the risk of cancer-specific mortality by a median of 61%. Smoking further increases the risk of developing a second primary cancer and has strong associations with an increased risk of toxicity from cancer treatment. One or more adverse effects of smoking are noted across virtually all cancer disease sites and for all treatment modalities including surgery, radiotherapy, and systemic therapy.
Yet despite these data, most oncologists do not regularly provide evidence-based tobacco cessation support for patients with cancer who smoke.2 Some of the reasons that oncologists do not offer this support include not feeling confident in their ability to assist their patients in stopping smoking, a lack of time, and a lack of available resources.3
However, addressing tobacco use by patients with cancer is not as difficult as some might think. Established evidence-based guidelines are available4 and online resources have been developed specifically for use by clinical oncologists.5 Recent reviews have discussed methods to improve cessation support for patients with cancer that basically rely upon asking patients about tobacco use, advising patients to quit smoking, and assisting patients in quitting smoking using principles of behavioral counseling and pharmacotherapy.6,7 Physicians and other clinical providers can directly assist patients with cessation support or can refer patients to resources such as dedicated institutional tobacco cessation programs, state help line services, or specialized counselors who can be integrated into a busy oncology clinic.
Recognizing the merits of such efforts, leading cancer organizations such as the American Society of Clinical Oncology, the American Association for Cancer Research, and the International Association for the Study of Lung Cancer have advocated for providing cessation support to all patients with cancer who use tobacco.8-10
Graham W. Warren, MD, PhD
Associate Professor
Vice Chairman for Research
Department of Radiation Oncology
Hollings Cancer Center
Medical University of South Carolina
Charleston, SC
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