The influence of smoking cessation after diagnosis of early stage lung cancer on prognosis - Dissertation Example

?The Influence of Smoking Cessation after Diagnosis of Early Stage Lung Cancer on Prognosis Introduction: “Smoking Is Injurious to Health” (Smoking Is Injurious to Health 2010) we hear this every now and then isn’t it? We all know smoking has a lot of ill effects on human body but still find many addicted to smoking. A practice of burning a substance like tobacco or cannabis and inhaling or tasting it is called Smoking. Cigarettes are the most common method of smoking. Pipes, Bidis, Cigars, Hookahs etc are other methods. A research shows that “half of all long term smokers will die” (It’s Never Too Late to Quit Smoking, Says Study 2012) due to disease related to smoking it suggests that “even non smokers” (Erik et al. n.d.) are prone to these diseases. Worldwide a “large number of people” (Types of Lung Cancer 2011) are killed because of these diseases. Study shows that “one out of two people” (Erikson n.d.) die due to their habit of smoking and that too many at their mid age. There is lot of harmful effects on the body like – Temporary increase of “blood pressure” and heart beat further straining the heart and blood vessels. The chances of “heart attacks, strokes, paralysis and weakness” (Pai 2011). There are “numerous cancers” associated with smoking. Smoking at young age “reduces IQ” of a person. The “blood circulation” is not proper which affects the body and skin. This also leads to weakness. It “damages the retina” thereby affecting the eyesight. Smoking “causes the bones to become weak” (Nutrition and Weak Bones 2010) leading to fractures. “Fertility” related problems are seen in both men and women. Smokers are prone to “kidney, stomach” related diseases. It also leads to “lung cancer” “Pregnancy” related issues are found in women who smoke. The new born child is also adversely affected. People who smoke have a “shorter life span.” Smoking can cause different types of cancer. These include Lung cancer, Mouth cancer, Throat, “Stomach” Esophagus, cancer of Kidney, cancer of Bladder, cancer in Pancreas etc. Lung cancer is one amongst the most “deadliest form of cancer.” (Epidemiology of Lung Cancer n.d.). Every year about“7.5 million people die” (U.N. Summit as World Cancer Toll Increases 2012) of lung cancer. The “survival” (Lung Cancer Survival Rate 2011) of the lung cancer patients depends on it’s diagnose stage and type. Now the question arises what exactly is Lung cancer. Due to series of changes in the cells in the lungs they tend to grow abnormally and “out of control” (Eldridge 2012). This type of behavior in the lungs is known as Lung cancer. This can occur any were throughout the lungs. Lung cancer is mainly classified in to two types, 1. “Small Cell Lung Cancer” (Lung Cancer n.d.). 2. “Non Small Cell Lung Cancer” (Lung Cancer n.d.). Small Cell Lung Cancer: Study reveals that around “10% to 15 %” (Lung Cancer (Small Cell 2012) of Lung cancer patients suffer from Small Cell Lung Cancer (SCLC). It “spread quickly” (Patient Information: Small Cell Lung Cancer Treatment (Beyond the Basics) 2012). It is more found in people who smoke than those who do not smoke. SCLC is considered as the “most aggressive form of Lung cancer” (Lung Cancer (Small Cell 2012). It tends to develop in the “bronchi” (Lung Cancer 2012) which is present in the centre part of the chest and later spreads to the other parts of the body. Small Cell Lung Cancer is also known as “oat cell cancer, oat cell carcinoma and small cell undifferentiated carcinoma” (Lung Cancer (Small Cell 2012). SCLC has further two other forms namely- “Small cell car cinoma (oat cell cancer)” (Small Cell Lung Cancer Treatment (PDQ®) 2012): This is one of the most malignant kinds of cancer. It grows within the lungs. “Combined small cell carcinoma” (Small Cell Lung Cancer Treatment (PDQ®) 2012). – It is a lung cancer which has different stages. It emerges in the form of a tumor in the lung tissue. Non Small Cell Lung Cancer: Around “85-90 %” (Lung Cancer 2010) of the Lung cancer patients suffer from Non Small Cell Lung Cancer (NSCLC).As compared to Small Cell Lung Cancer it spreads slowly. The Lung cancer in non-smokers is mostly NSCLC. NSCLC is divided in three forms namely – “Adenocarcinoma” (Types of Lung Cancer 2011): In this one of the cell which secrets “mucin”, a thick coating consisting of carbohydrate that protects lungs in case of injury, becomes cancer. “Squamous cell carcinoma” (Types of Lung Cancer 2011): It begins at tissue of lungs airways. The tumors can even form cavities in lungs of they become large. “Large Cell Carcinoma” (Types of Lung Cancer 2011): This type of lung cancer begins at the outer area of the lungs. They grow rapidly. Smoking is the primary cause of lung cancer. Regular smokers are more subjected to lung cancer. One could ask if quitting smoking can help lung cancer patients. Well Yes it does help if a person who smokes keeps himself away from the harmful smoke of cigarettes and other such toxic substances. Lets us first discuss how lung cancer is related to smokers. Lung Cancer in Smokers: Lung cancer can be found in both people who smoke and those who have never smoked in their lifetime. But statistics shows that lung cancer is more prominent in smokers. It depends on the “number of cigarettes smoked per day and the number of years a person has smoked”. A middle aged man who smokes less than “25 cigarettes a day has a 9 percent chance of dying from lung cancer. A heavy smoker,25 cigarettes or more a day, has an 18 percent chance of death.Very heavy smokers who have smoked throughout most of her or her life have a 30 percent chance of death” (Mulwane 2011). Cigarette smoke contains small particles consisting tar, gases such as “carbon monoxide” and “nitrogen oxide”. When the smoke enters the lungs it causes “genetic changes” in the lung cells and damages it. This leads to the growth of these cells uncontrollably leading to cancer. Global, lung cancer is the most generally diagnosed type of cancer. In UK, its yearly occurrence is second only to that of the decease breast cancer, accounting for about 39000 diagnoses of new cancer yearly. “People diagnosed with early stage lung cancer can double their chances of survival over five years if they stop smoking compared with those who continue to smoke” (Lung Cancer Patients Who Quit Smoking Double Their Survival Chances 2010). In states that have seen a high occurrence of smoking, approximately 90% of diagnoses of lung cancer that are attributable to reason of smoking cigarette. The increased occurrence from smoking of the cigarettes is proportional to the intensity and length of history of smoking. On average, a life smoker has a 20-fold enlarge in the risk of rising lung cancer as it is compared with a life non-smoker. “Lung cancer is the cancer most commonly associated with smoking: around 85-90% of all lung cancers are caused by smoking, or as a result of exposure to secondhand smoke. Because of its poor prognosis, lung cancer is still the most common cause of cancer death, responsible for around 1 in 5 of all cancer deaths in the UK. Fewer than ten percent of people with lung cancer will survive five years beyond diagnosis” (Eldridge 2012). Lung cancer is more general in gents than in women, intimately subsequent past patterns of smoking occurrence, and 80% of situations are diagnosed in citizens aged above 60. Smoking cessation previous to diagnosis decreases the risk of building up primary tumour of every major histological kinds of lung carcinoma; the utmost reduction is seen in squamous cell and small cell tumours. On the other hand, whether smoking cessation subsequent to diagnosis of a lung tumour can develop endurance rates is less clear. The biological devices by which toxins substance in tobacco smoke origin lung cancer are very complex and still not wholly comprehended, but carcinogens in smoke in tobacco may not only act as hereditary inducers but also act to encourage progression of the various kinds of disease. “The most frequent histological type is non-small cell lung cancer (NSCLC), which includes adenocarcinoma and squamous cell carcinoma” (Hodkinson & Sethi 2011). In addition to potentially dropping the risk of cancer connected mortality and morbidity, stopping smoking at diagnosis could decrease on the whole mortality, as smoking cessation decreases mortality from other types of diseases for example stroke, heart disease and chronic obtrusive airways disease. Quitting the habit of smoking subsequent to a diagnosis of early- phase lung cancer may decrease the risk of cancer death and recurrence. Lung cancer is the one of the leading reason of cancer death in the UK. “The WHO Framework Convention on Tobacco Control (WHO FCTC) is the first treaty negotiated under the auspices of the World Health Organization. The WHO FCTC is an evidence-based treaty that reaffirms the right of all people to the highest standard of health” (WHO Framework Convention on Tobacco Control 2003). Cessation of smoking is recognized to decrease a smoker’s risk of developing the decease lung cancer, but less is recognized regarding the consequence of cessation of smoking subsequent to a lung cancer diagnosis. “Smoking cessation lowers the risk for lung and other types of cancer” (Smoking and Tobacco Use 2011). To assess the result of quitting smoking subsequent to a lung cancer diagnosis, researchers assessed information from numerous previously published and available studies. The majority of the studies are give attention on patients with early- phase decease of lung cancer. Between patients by way of non–small cell lung cancer, those who sustained to smoke subsequent to diagnosis were nearly three times more expected to die and about twice as expected to experience a recurrence of cancer as those who discontinued smoking. Even though earlier cessation of smoking would likely offer greater advantages, the effects of this analysis recommend that smoking cessation subsequent to a diagnosis of early lung cancer may progress and develop outcomes. Prognosis of one of the major decease lung cancer is poor; approximately 7% of patients that are survive for 5 years, and the majority of the treated of the patients are palliatively from diagnosis. The discomfort and complexity of cessation of the smoking may denote that many patients with superior and advanced disease decide to continue smoking. “Smoking contributes to cancer development by causing mutations in tumor suppressor genes and dominant oncogenes and by impairing mucociliary clearance in the lungs and decreasing immunologic response” (Smoking Cessation and Continued Risk in Cancer Patients (PDQ®) Health Professional Version 2012). The cancer reform policy of the UK has called for support for survivors and superior services and of cancer normally, and interferences to support smoking termination subsequent to diagnosis tailored to the requirements of lung cancer patients might be part of these. Such interference must be based on robust proof that quitting smoking really improves results. “In order to help eliminate the tobacco epidemic, a comprehensive package of Dutch tobacco control interventions has been implemented for many years now.28 However, the National Cancer Control Programme (NCCP) for 2005-2010 reported that the aim to reduce the overall prevalence of current smokers to 20% in 2010 was not achieved” (Aalst 2011). The latest cancer occurrence statistics obtainable for2009 for the UK, and for mortality the most recent statistics are for 2010. Lung cancer is the one of the second most general cancer amongst men in the UK, accounting for approximately 14% of every new cases of cancer in gents. It is also the third most universal cancer amongst women, accountable for in excess of 11% of every new cases of cancer in ladies. “Table 1.1: Lung Cancer (C33-C34), Number of New Cases, Crude and European Age-Standardized (AS) Incidence Rates per 100,000 Population, UK, 2009 England Wales Scotland Northern Ireland UK Male Cases 18,517 1,294 2,637 593 23,041 Crude Rate 72.6 88.3 104.8 67.5 75.9 AS Rate 56.3 60.6 80.7 61.6 58.8 AS Rate – 95% LCL* 55.5 57.3 77.7 56.7 58.0 AS Rate – 95% UCL* 57.2 63.9 83.8 66.6 59.5 Female Cases 14,633 962 2,352 440 18,387 Crude Rate 55.6 62.7 87.8 48.3 58.5 AS Rate 37.5 38.0 57.1 38.2 39.3 AS Rate – 95% LCL* 36.9 35.6 54.8 34.7 38.8 AS Rate – 95% UCL* 38.1 40.4 59.4 41.8 39.9 Persons Cases 33,150 2,256 4,989 1,033 41,428 Crude Rate 64.0 75.2 96.1 57.7 67.0 AS Rate 45.8 47.9 67.0 48.3 47.9 AS Rate – 95% LCL* 45.3 45.9 65.2 45.3 47.4 AS Rate – 95% UCL* 46.3 49.9 68.9 51.2 48.3 (Lung cancer - UK Incidence Statistics 2012). In excess of 85% of every lung cancer cases happen between people who are either former or current tobacco smokers. The relation among lung cancer and smoking is originated by the carcinogens that have present in smoke the tobacco. The risk of rising lung cancer from smoking is persuaded by numerous factors consisting of the age at which an individual started smoking. The younger an individual was at the time he or she began smoking, the bigger the possibility of lung cancer. “Quitting smoking has immediate and longer term benefits at any age. Research shows that the risk of dying from lung cancer at 75 is reduced by 87.5% if a person quits at 30, by 81% if quitting occurs at 40, 62.5% at 50 and 37.5% at 60.10” (Facts on Smoking and Lung Cancer n.d.). Benefits of Smoking Cessation in Lung Cancer: Smoking is like fuelling the process of cancer. Thus a patient who still continues smoking is progressing his cancer and is rapidly heading towards death. Secondly the chemicals involved in the smoke of cigarettes interfere with the treatment that is chemoradiotherapy. The nicotine has high potential “to induce hepatic enzymes” (Lewis 2010, p. 94) which clears the agents of chemotherapy. It also leads to side effects damaging the lungs and affecting the immune system thus increasing the risk of infections. Smoking has an adverse effect on the treatment of lung cancer and the effectiveness of the treatment is reduced. Quitting smoking has a major impact on the lung cancer patients. The immediate effects that have been noticed are that the blood circulation in the body improves drastically, the lungs starts functioning properly. “Within 1-9 months of quitting, the ciliary function” (Roth et al. n.d.) of the lungs is restored. In the beginning the patients tend to cough more as the unwanted mucus and particles of smoke is removed by the lungs. When the cessation is done over few months the coughing is reduced, sinus and lung congestion is reduced, fatigue is reduced, and the patient is able to breathe properly. A patient’s chance of getting pulmonary infection is decreased. When the period reaches one year his risk of contracting heart disease is reduced. If a person stops smoking for 5-15 years his chances of stroke is negligible. And if he stops it for 10 years the risk of his dying due to lung cancer is relatively low as compared to those who still continue smoking. Many who smoke feel that the “damage is done” (Lewis 2010) and it’s of no use quitting smoking are actually wrong. Research has proved that a person who quits smoking lives more than the one who smokes. A person who is 35 years of age would add 6-9 years to his life than a person who still continues smoking. There is evidence which shows that even a person whose age is above 65 years of age would add additional age to his life if he quits smoking. Hence it is never late and so even elderly people should be encouraged to quit smoking. Cessation of smoking is also beneficial for those who are undergoing treatment for lung cancer. There is less complication in non smokers than for those who still continue smoking. The one who continued smoking after lung cancer detection needed more “cemoradiotherapy” (Influence of Smoking Cessation after Diagnosis of Early Stage Lung Cancer on Prognosis: Systematic Review of Observational Studies with Meta-Analysis 2010) breaks compared to those who already quit smoking. The survival rate is poor in case of those who continue smoking even after diagnosis. Smoking cessation is very beneficial in avoiding growth of any second tumor in the lungs and other body parts. Continued smoking may lead to development of new tumors. The chances of lung cancer for the second time are increased. Conclusion: This summary briefly encloses smoking as one of the major risk factor for the decease lung cancer, but the major focus is on the outcome of smoking on diagnosis or recurrence of a second primary cancer; molds of continued and quitting smoking in patients with cancer. This data will help health experts caring for patients for the period of and subsequent to treatment. Substantial substance on smoking cessation and cancer avoidance in the general inhabitants is obtainable elsewhere. Lung cancer can be found in both people who smoke and those who have never smoked in their lifetime. But statistics shows that lung cancer is more prominent in smokers. Because nearly all the obtainable facts pertains to smoke cigarettes rather than other types of tobacco for example chewing tobacco or snuff, reference is made to cigarettes smoking rather than to use tobacco. Reference List Aalst, C.M.V.D. (2011). Smoking, Smoking Cessation, and Lung Cancer Screening in the NELSON Trial. 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