Quitting smoking improves cancer surgery outcomes..

June 22, 2009 - Even a short period of 4 to 8 weeks of smoking cessation prior to surgery for cancers of the mouth and throat improves wound healing, according to a new review. Furthermore, if the patient stays tobacco-free, the risk of cancer recurrence is substantially reduced.

However, full cessation is required; simply reducing the number of cigarettes smoked per day is of little benefit, Dr. Richard O. Wein from Tufts Medical Center, Boston, reports in the Archives of Otolaryngology--Head and Neck Surgery.

Although there are conflicting reports concerning the impact of short-term smoking cessation, Wein says, the sheer number of studies reporting the negative impact of continued tobacco use on postop lung function and wound healing "far outweighs those minimizing this impact."

Furthermore, multiple studies indicate increased risk of recurrence or the development of a second cancer in patients who continue to smoke after their cancers are diagnosed. One study, for example, found that 40 percent of patients who kept smoking after being treated for an oral cavity tumor had a recurrence or developed a second malignancy.

Unfortunately, people with a diagnosis of a mouth or throat cancer don't usually have the luxury of taking 2 months to stop smoking before surgery, because an operation is imperative, Wein notes.

"In these scenarios," he concludes, "although the impact of short-term (less than 2 weeks) preoperative smoking cessation on the immediate post-operative course may be modest, the long-term cardiopulmonary benefits and the potential decrease in the development of future smoking-related (malignancies) with sustained cessation are undeniable."

PAPER: Preoperative Smoking Cessation Impact on Perioperative and Long-term Complications, Richard O. Wein, MD, Arch Otolaryngol Head Neck Surg. 2009;135(6):597-601, ABSTRACT...