Quitting Smoking Before Laryngeal Cancer Treatment Improves Survival

Implementing tobacco cessation programs for patients with laryngeal cancer who actively smoke may help them quit, an expert said.

Patients newly diagnosed with laryngeal cancer who stopped smoking before receiving treatment had increased responses to treatment, and researchers also saw beneficial survival outcomes in these patients, a recent study showed.

In the study published in Otolaryngology-Head and Neck Surgery, researchers included 140 current smokers with laryngeal cancer. Of the total patients, 61 (45%) quit smoking before receiving treatment, the study noted.

Laryngeal cancer is located in the throat where the vocal cords are, according to the National Cancer Institute. Tobacco products and excessive drinking of alcohol may contribute to the risk of laryngeal cancer.

An analysis revealed that individuals who quit smoking had “3.7 times higher odds of achieving a complete response to first-line therapy than active smokers,” the researchers wrote.

Implementing a tobacco cessation program for laryngeal cancer treatment plans is important, said lead study author Dr. Lurdes Queimado, in a press release.

“To the best of our knowledge, this is the first study to suggest that in newly diagnosed laryngeal cancer patients who are smokers at the time of diagnosis, those who quit before treatment begins will have a much better prognosis than those who continue smoking,” Queimado said in the release.

Queimado is a researcher and professor of otolaryngology-head and neck surgery at the University of Oklahoma College of Medicine.

“We are excited about these findings because it gives our patients some hope. If chemotherapy and radiation don’t work, they may need to have their voice box removed, and that often brings stigma and depression,” she said. “Their quality of life significantly decreases because they have a lot of difficulty swallowing and have to talk through a tube.”

READ MORE: ‘More is Not Always Better’ in Chemoradiotherapy for Head and Neck Cancer

Patients who quit smoking before treatment had a higher seven-year laryngectomy-free survival versus active smokers, the study showed. Researchers defined laryngectomy-free survival as the start of chemoradiation or definitive radiation until salvage laryngectomy or the last date of contact.

A laryngectomy is a type of surgery that removes the voice box, according to the Cleveland Clinic. A study published in Laryngoscope Investigative Otolaryngology explained that a salvage laryngectomy is the procedure after receiving chemoradiation.

Of note, patients who quit smoking were 54% less likely to require a salvage laryngectomy within seven years of their diagnosis, researchers stated.

Researchers also analyzed smoking status and overall survival in this patient population. Overall survival is the time from diagnosis when patients are alive with cancer, according to the National Cancer Institute.

At three years, the overall survival among the entire patient population in the study was 76%, researchers found. At five and seven years, the overall survival for the entire population was 71% and 67%, respectively.

The study also separated overall survival among active smokers and patients who quit smoking before treatment.

The overall survival at three, five and seven years for patients who quit smoking before treatment was 83%, 79% and 75%, respectively.In patients who were active smokers, the overall survival at three, five and seven years was 66%, 60% and 56%.

“To have such an improved quality of life for seven years is significant,” Queimado said in the release. “In most patients, we treat with chemotherapy and radiation first to try to spare the voice box because it is so vital for speaking and swallowing. Because of those quality of life issues, the impact of this study is beyond what we measured.”

Queimado also emphasized that “it will make a difference” for patients with laryngeal cancer to have support to help them quit smoking.

“A diagnosis of cancer is overwhelming, and people’s lives are turned upside down, so unless services are taken to them, they are less likely to pursue them on their own,” she said. “It is very difficult to quit smoking, but I think it will make a difference if we can surround the patient with the support and tools they need to quit. And if they quit during their treatment, maybe they will never go back to it.”

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