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Ditch habit for longer survival after head and neck cancer, smokers urged

Smokers who quit for 15 years benefit most, study finds

Caroline White

Monday, 22 August 2016

Not only is quitting smoking linked to improved survival prospects after radical treatment for head and neck cancer, but every year as an ex-smoker counts, with 15 or more years having the greatest impact, finds a study* published in the British Journal of Oral and Maxillofacial Surgery (BJOMS).

The findings prompt the researchers to call for the smoking status of patients to be recorded accurately in future clinical trials so that surgeons can use the data to encourage patients to ditch their habit and improve their chances of survival.

They base their findings on the survival outcomes of 521 patients treated for head and neck cancer between 1992 and 2013.

Some 121 were non-smokers; 177 were current smokers; and 214 were ex- smokers.

In all, 317 patients were treated by resection, 98 by resection and adjuvant radiotherapy, seven by resection and adjuvant chemoradiotherapy, and 24 by primary radiotherapy. Of these, 169 patients died and 97 developed a recurrence.

The researchers found a significant difference in the survivals of ex and current smokers, which increased when reformed smokers were grouped according to how long they had quit smoking.

Not only were smokers who quit less likely to develop head and neck cancer, they had significantly better survival rates when they were diagnosed with the disease, the findings showed.

And the longer they had given up the better their chances of survival were, with 15 or more years as an ex-smoker affording the greatest health protection, the data analysis showed.

People who smoke are six times more likely to develop head and neck cancer. David Mitchell, BJOMS Editor and consultant maxillofacial surgeon, says: “Current research shows that smokers get more aggressive forms of the disease than non-smokers.  

“As facial surgeons we need better information to help us encourage patients to give up smoking so that they have a far better chance of survival, which is why this review of data is so important.”

The researchers call for the smoking status of patients to be documented accurately in future clinical trials, with smokers grouped into at least three categories that separate former users from current users, and including number of years the individual has stopped smoking.

Consultant maxillofacial surgeon, and deputy lead for the British Association of Oral and Maxillofacial Surgeons Oncology Sub Specialty Interest Group, Mike Bater, comments: "Patients with head and neck cancers benefit considerably from stopping smoking. Not only does this reduce the risk of the cancer recurring, it also makes it less likely that further head and neck cancers will develop in the future.

“Additionally, we know that patients with head and neck cancers that stop smoking recover quicker if they are treated by surgery, as they tend to get less postoperative complications and have better wound healing.”

Deborah Arnott, chief executive of Action on Smoking and Health (ASH), commented: “Smokers are up to four times more likely to quit successfully if they get help from the stop smoking services, and smokers undergoing cancer treatment should be given specialist help to stop.”

* Cao W, et al. Reformed smokers have survival benefits after head and neck cancer. British Journal of Oral and Maxillofacial Surgery, September 2016, Volume 54, Issue 7, Pages 818–825. DOI: 10.1016/j.bjoms.2016.06.013

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