Can Quitting Smoking Easily Be a Symptom of Lung Cancer?

An article in the most recent issue of the Journal of Thoracic Oncology detailed a study on patients who quit smoking with ease. The study showed that patients whose experience in quitting smoking had few or no troubles also developed lung cancer within three years of quitting. The study subjects quit smoking well before they exhibited any sings of the disease, which has convinced researchers that the comparative easiness of how the patients were able to quit could also be a symptom of lung cancer itself.

Researchers at the Thomas Jefferson University Medical Center in Philadelphia have hypothesized that active lung cancer cells release a compound that counteracts the body’s dependence on nicotine, the active ingredient in tobacco. Since one of the primary obstacles that smokers come across when attempting to quit smoking is nicotine addiction, the hardest part of quitting becomes much easier, albeit at a severe cost to the patient’s health.

The study looked at the behavior 115 former smokers who were later diagnosed with lung cancer. Out of those 115, 55 had gone through some type of program to quit smoking, such as nicotine gums or patches, well before they were diagnosed with the disease, with 31 reporting that they quit with ease. The data revealed that patients who had stopped smoking with very little or no difficulty showed symptoms of lung cancer in just over two years.

Dr. Barbara Campling and her team of researchers conducted the tests with patients at the Philadelphia Veterans Hospital. Dr. Campling and her group ascertained the level of the patient’s nicotine addiction through an interview and psychological test. The data from those tests showed that the patients who said they quit with ease were just as addicted to nicotine as those who either quit with difficulty or continued to smoke.

Dr. Campling also pointed out that her team’s findings might refute much of the popular belief behind smoking cessation and lung cancer. Many doctors previously believed that smokers eventually quit due to the visible symptoms of lung cancer, including heavy coughing and other respiratory issues, which made the task of inhaling the smoke more difficult.

The findings of this new study, despite the limited number of participants, have opened up other ideas on how to detect lung cancer in smokers. The news may lead to smokers who suddenly lose their cravings for nicotine to visit a doctor and determine if they are undergoing the early stages of lung cancer. As with most cancers, early detection is a key to any possible recovery.

The study may also lead to other potential applications for smoking cessation programs. If scientists can isolate the agent that induces the patients in the study to quit smoking immediately and painlessly, such a discovery could lead to new forms of therapy to help smokers quit the habit much easier.

Dr. Campling also suggests that smokers do not take the findings as a justification for continuing to smoke. She said that a smoker who does not consider quitting based on her study has “the absolutely wrong interpretation” of the findings.

Sources:
http://topnews.net.nz/reports/212505-ease-quitting-linked-lung-cancer
http://www.philly.com/philly/entertainment/20110307_If_quitting_comes_easy.html
http://www.washingtonpost.com/wp-dyn/content/article/2011/03/07/AR2011030703659.html

Fatigue and Mesothelioma

Fatigue is a common symptom of advanced mesothelioma. Fatigue is also commonly linked with cancer treatment and has an occurrence rate of 90% among patients receiving chemotherapy. There are many potentially underlying causes for both the symptoms. In majority of patients, the etiology of both the symptoms is multifactorial, with several of these contributing interrelated abnormalities. For instance, in a study involving patients with advanced cancer, it was noticed that fatigue correlated significantly with the intensity of dyspnea. This article will elaborate on the mechanisms, clinical features, assessment, and management of fatigue and dyspnea, which are two of the most common and often undertreated symptoms among cancer patients.

Fatigue

The National Comprehensive Cancer Network defines cancer-related fatigue as “a distressing, persistent, subjective sense of tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.” Fatigue is often severe among cancer patients; has an identifiable anticipatory component; and results in general malaise, lack of energy, diminished mental functioning, and lethargy, all of which significantly impair quality of life. Fatigue can occur early during the progression of the disease; may worsen due to treatment, and can be found in almost all individuals with advanced cancer.

Sometimes, fatigue is referred to as tiredness, exhaustion, weakness, lack of energy, and asthenia. However, these terms may have varying implications for different patient populations. Further, different studies on fatigue and dyspnea have focused on different outcomes, which range from physical performance to just the subjective sensation.

Mechanism

The mechanisms involved in cancer-related fatigue are not clearly understood. It has been postulated that substances produced by the tumor result in fatigue. When blood from a fatigued subject was injected into a rested subject, it demonstrated manifestations of fatigue. When cytokines are produced in the host in response to the tumor, the same can also create a direct fatigue-inducing effect. Other potential causes of chemotherapy- or radiotherapy-induced fatigue include muscular or neuromuscular junction abnormalities. Hence, it can be concluded that fatigue results from not just one, but several different syndromes. In most patients with advanced cancer, multiple mechanisms are responsible for causing fatigue.

Clinical Features

In an individual patient, there are often multiple causes of fatigue with many interrelated factors.

Cachexia

A complex interaction of host and tumor products leads to cancer cachexia. Host cytokines, for instance tumor necrosis factor, interleukin-1 (IL-1), and IL-6 can potentially cause reduced food consumption, loss of body weight, a reduction in synthesis of both proteins and lipids, and increased lipolysis. Profound weakness and fatigue can be caused by the metabolic abnormalities responsible for the production of cachexia as well as the loss of muscle mass due to progressive cachexia. However, there are several abnormalities that can cause profound fatigue in patients who may not be experiencing significant weight loss.

Immobility

Reduced physical activity has demonstrated to cause deconditioning and diminished endurance to both physical exercise and routine daily activities. In comparison, overexertion is often the cause of fatigue among non-cancer patients. At risk are younger cancer patients receiving aggressive antineoplastic treatments, for instance radiation therapy and chemotherapy, and those who are making efforts to maintain their professional and social activities.

Psychological distress

In case of non-cancer patients who experience fatigue, the final diagnosis in around 75% of patients is psychological (for instance anxiety, depression, and other types of psychological disorders). The occurrence rate of major psychiatric disorders among cancer patients is relatively low. Nonetheless, symptoms of adjustment disorders and psychological distress with anxious or depressive moods are more common. Fatigue is often the most prevalent symptom among patients with a major depressive disorder or adjustment disorder.

Anemia

Low red blood cell count, if induced due to chemotherapy or advanced cancer, has been linked with fatigue, and treatment of the same helps improve symptoms of fatigue and quality of life among these patients. However, treatment of anemia among terminally ill patients may not help improve fatigue satisfactorily due to the multifactorial characteristic of its etiology. Fatigue can also occur due to the relatively more intense characteristics of other contributory factors.

Autonomic failure

Autonomic insufficiency is a medical complication that occurs frequently among patients with advanced cancer. Instances of autonomic failure have also been seen among patients with a specific type of severe chronic fatigue syndrome. While the connection between fatigue and autonomic dysfunction has not yet been established among cancer patients, the same should be suspected among patients with signs of autonomic failure including severe postural hypotension.

Heavy Cigarette Smoking On the Decline

A recent report from researchers at the University of California at San Diego has revealed that the habit of smoking at least one pack (20 cigarettes) a day has severely declined over the last fifty years. Investigators observed that the rate of decline was particularly noteworthy in California, where lung cancer rates also fell in proportion to the reduction in smoking rates. The data and the corresponding interpretation of the study were printed in the Journal of the American Medical Association’s March 2011 issue.

The UCSD study showed how much smoking has declined since the early 1960s. According to reports, more than fifty percent of all adult smokers in the US smoked at least one pack per day. That number fell to just over forty percent by 2007. “Moderate” smoking (10 to 20 cigarettes a day) rates also fell. In California, the number of moderate smokers fell from 11.1 percent of all adults in 1965, down to 3.4 percent in 2007. In other states, the number fell from 10.5 percent of all adults down to 5.4 percent.

The study credits much of the decline to smoking education programs. In 1964, the US Surgeon General released the first major findings on the correlation between cigarette smoking and lung cancer. Two years later, the Food and Drug Administration required mandatory warning labels on all cigarette packaging. Today, most cigarette packs and cartons carry warning labels, including warnings about how smoking can complicate pregnancy and lead to low birth rates in pregnant women who smoke.

Another factor attributed to the reduction in smoking rates is the development in new technologies to combat nicotine addiction. One of the primary reasons that smokers find quitting so difficult is the intense nicotine addiction that smoking brings. The invention of nicotine patches, lozenges and gums as part of a smoking cessation program has helped millions of smokers quit the habit over the last twenty years.

In addition to federal mandates requiring the addition of warning labels to cigarette packaging, many state and municipal jurisdictions created anti-smoking laws and ordinances. Several states added higher taxes to cigarettes, with California among the first to enact such statutes. Also, many cities passed local laws prohibiting smoking in bars, restaurants and public buildings.

Public awareness campaigns, such as those conducted by the American Heart Association, the American Lung Association and the American Cancer Society, also helped bring the issues of cigarette smoking to the attention of the American public. The campaigns highlighted many of the dangers that surround cigarette smoking, including lung cancer, throat cancer and emphysema.

As California took the lead in many of the anti-smoking efforts, the study also showed how lung cancer incidence rates declined in the state well before other states saw the same results. Deaths from lung cancer peaked in 1987 in California, with 109 per 100,000. The death rate fell to 77 per 100,000 in 2007. In other states, the lung cancer death rate peaked in 1993 at 117 per 100,000 and fell to 102 per 100,000 in 2007.

Sources:
http://www.npr.org/blogs/health/2011/03/16/134597676/heavy-smoking-is-fast-becoming-history?ps=sh_sthdl
http://www.wtma.com/rssItem.asp?feedid=116&itemid=29645079
http://health.usnews.com/health-news/managing-your-healthcare/articles/2011/03/15/heavy-smoking-declines-in-us
http://www.webmd.com/smoking-cessation/news/20110315/heavy-smokers-us-dwindling
http://www.cnn.com/2011/HEALTH/03/15/pack.smokers.now.rare/index.html
http://www.medicalnewstoday.com/articles/219085.php
http://www.latimes.com/health/boostershots/la-heb-california-smoking-20110316,0,5345363.story
http://en.wikipedia.org/wiki/Tobacco_packaging_warning_messages#United_States_of_America