A CANCER DIAGNOSIS COMES WITH A SERIES OF DECISIONS, from selecting a doctor to choosing among treatments. A National Cancer Institute (NCI) initiative aims to help cancer patients who use tobacco add one more consequential decision to their list: to quit.
The new Cancer Center Cessation Initiative awarded 22 NCI-designated cancer centers each $250,000 annually over two years beginning in October 2017 to enhance their smoking cessation programs. The initiative stemmed from recommendations made in 2016 by the Cancer Moonshot Blue Ribbon Panel, whose expertise helped guide the Moonshot’s cancer prevention, research and treatment goals.
“We’ve got this enormous paradox in America that about 30 percent of all cancer deaths are directly caused by smoking, and yet we have patients diagnosed with cancer who are entering and exiting cancer centers and the cause of [their] cancer is often not addressed,” says Michael Fiore, director of the University of Wisconsin Center for Tobacco Research and Intervention in Madison. (The University of Wisconsin Carbone Cancer Center is the coordinating center for the project.) “This initiative is designed to successfully address this challenge.”
Quitting smoking can improve outcomes after radiation, chemotherapy and surgery, as well as reduce risk of developing subsequent cancers. Evidence-based treatments that help in quitting include counseling and U.S. Food and Drug Administration (FDA)-approved medications, such as gums and patches as well as drugs like Chantix (varenicline) and Zyban (bupropion).
There are 62 NCI-designated cancer centers that see patients. Glen Morgan, a clinical psychologist at the NCI’s Tobacco Control Research Branch, says he hopes the 22 selected centers become exemplars of how cancer patients who use tobacco should be treated.
Some cancer centers will use the funding to improve and expand their tobacco cessation programs; others will build cessation programs from the ground up. Some intend to tailor their electronic medical records to prompt health care providers to talk to patients about their tobacco use and automatically generate referrals to the cancer center’s tobacco cessation program or an outside quitline.
Several cancer centers, including the University of Kentucky Markey Cancer Center in Lexington, will also implement education programs that teach clinicians how to talk about tobacco with their patients. University of Kentucky psychologist Jessica Burris says that clinicians may believe that it’s an uphill battle to get patients to address tobacco use while they are making cancer treatment decisions, especially in states like Kentucky, which is estimated to have the second-highest rate of adults who smoke in the U.S. “When you have a long history of feeling that you’re not helping people or that you’ve not been successful, you can adopt an attitude of pessimism,” she says.
Representatives from the cancer centers will communicate regularly to share information about the efforts they are engaged in to get the specific types of patients they see—for instance, urban or rural, Latino, Native American, African-American or white—into cessation programs.
“We want to make [smoking cessation] part of standard care, [so that for] every cancer patient who smokes, we work toward improving their health by delivering these services,” says Morgan.
“Being able to successfully quit smoking or any tobacco use is big,” says Burris. “To be able to be successful [at quitting] for any long period of time is a boon to self-esteem and quality of life.”
Cancer Today magazine is free to cancer patients, survivors and caregivers who live in the U.S. Subscribe here to receive four issues per year.
