Head and Neck Cancer Survivors Who Use Alcohol and Cigarettes Have Increased Death Risk
Cigarette smoking and alcohol consumption before a head and neck cancer diagnosis strongly predict the patient’s future risk of death, according to previously published studies. Now, results of a new study show a similar effect among those who continued these habits after their cancer diagnosis.
W. Jarrard Goodwin, M.D., director of the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, was a senior author of the study. “We found that survivors who smoked after their diagnosis,” said Goodwin, “were two times as likely to die.”
“Most cancer survivors are counseled to quit smoking; despite this, many still smoke. In our study, 21 percent continued to smoke even after their cancer diagnosis, increasing their risk of death,” said lead researcher Susan T. Mayne, Ph.D., professor of epidemiology at the Yale Schools of Public Health and Medicine. They also found that patients who drank alcohol were three times as likely to die following their diagnosis.
Based on their findings, Goodwin and Mayne advise survivors of head and neck cancer — which includes cancers of the oral cavity, pharynx and larynx — to quit smoking cigarettes and drinking alcoholic beverages in order to increase their odds of longer survival.
Results of this study are published in the December issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research. The issue has a special focus on tobacco. The research, funded by the National Cancer Institute, was conducted as a partnership between Sylvester and the Yale Comprehensive Cancer Center.
Mayne, Goodwin and colleagues evaluated the habits of 264 recent survivors of early stage head and neck cancer before and after their cancer diagnosis. Patient recruitment was conducted at 49 hospitals in Connecticut and Florida. After more than four years of follow-up, 62 patients died.
Patients who continued to smoke were approximately two times as likely to die during the follow-up, compared with those who did not smoke after diagnosis. Patients who continued to drink after diagnosis were approximately three times as likely to die during the follow-up, according to Mayne, who is also associate director of the Yale Comprehensive Cancer Center.
“We expected to see an adverse effect of continued smoking; I was really not sure what we would find for continued drinking,” she said. “The data from our study indicated that continued drinking should be discouraged in head and neck cancer survivors.”
“It’s clear to us,” said Goodwin, “that patients need assistance with both tobacco and alcohol cessation and that element should be incorporated into their survivor care.”
Yale researchers are conducting studies to determine the most effective ways to help head and neck cancer survivors stop smoking. One preliminary study will compare medications to help survivors quit, and will specifically focus on the effectiveness of varenicline (Chantix) compared with the nicotine patch. Some evidence has shown that varenicline may also help reduce alcohol consumption in patients. Given these findings, the researchers will monitor alcohol use and address potential methods to help patients quit.