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Fitness & Exercise for Senior Citizens
Exercise Provides Significant Reduction in Lung Cancer
Risk for Women Smokers
Almost half who have lung cancer surgery smoke
again in a year, says another study
 December 11, 2006 - A new study shows about half
the smokers who had surgery to remove early stage lung cancers were
smoking again within a year. Some also continued to smoke after their
diagnosis right up to the day of their surgery. It's a tough addiction
to break. But there is also good news in another new study: a high level
of physical activity in women smokers reduced their relative risk of
developing lung cancer by 72 percent. The lowest risks were seen in
former smokers who had moderate or high activity levels. The study,
however, strongly cautions that any exercise benefit is dwarfed by the
benefits gained from quitting smoking.
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Senior Citizen Fitness & Exercise |
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This study, which looked at more than 36,000 women,
also found that even moderate activity among smokers was associated with
a 65 percent risk reduction.
(Read report on study of
smoking after lung surgery below this story.)
The researchers, from the Universities of Minnesota
and Pennsylvania, report their findings in the December issue of Cancer
Epidemiology Biomarkers & Prevention.
While this may sound like welcome news to female
smokers who don’t want to quit, the investigators emphasize that the
absolute risk of developing lung cancer is still much greater in current
and former smokers regardless of activity level.
"The most important thing a smoker can do to reduce
risk is to quit smoking. That said, exercising and being active can
offer a marginal change in risk," said the study’s lead author, Kathryn
Schmitz, Ph.D. an assistant professor at the University of Pennsylvania.
Schmitz worked on the study with a team of researchers while on faculty
at the University of Minnesota.
In other words, she says, a physically active
smoker has a 35 percent lower risk of lung cancer than a sedentary
smoker, but if both smokers quit, they would both reduce their risk by
as much as 10- or 11-fold. "Smokers who exercise are at a 35 percent
lower risk of developing lung cancer relative to smokers who don’t
exercise, but if you smoke at all, your risk of developing lung cancer
is 10- to 11- fold higher than if you didn’t smoke."
"The helpful message from this study is that if a
smoker is having trouble quitting, exercise can be a first step toward
better health," says Schmitz.
The findings were derived from the Iowa Women’s
Health Study, which in 1986 began to follow almost 42,000 women between
the ages of 55 and 69. Over the years, five questionnaires were sent to
the participants who recorded their smoking status and physical activity
among other variables.
This analysis, which began in 2002, included 36,410
participants, including 777 women diagnosed with the cancer. Among this
group, 125 were non-smokers, 177 were former smokers, and 475 were
current smokers.
Compared to women who were physically active, women
with a low physical activity level at the baseline analysis were more
likely to smoke, less likely to have a high school education and more
likely to be obese.
Among smokers, the most number of cancer cases
(324) were seen among women who currently smoked and had low activity,
and the lowest number (40) was in the group of women who formerly smoked
and were highly active. Compared to never smokers, current and former
smokers had proportionally more squamous cell and small-cell lung
cancer, which can be harder to treat than other subtypes.
Researchers don’t know why activity could lower
lung cancer risk, but suggest that improved pulmonary function may
reduce both the concentration of carcinogenic particles in the smoker’s
airway and the extent to which they are deposited in the lungs. They
also theorize that exercise training improves immune function and
reduces the inflammatory responses that can impact cancer development.
"This may be useful information for smokers who are
not currently willing to attempt smoking cessation or have recently
failed a quit attempt," says Schmitz.
"But even if there was a significant risk
reduction, quitting smoking is unarguably the most important action a
person can take for reduction of lung cancer risk."
The study was funded by the National Cancer
Institute.
Lung Cancer Surgery Does Not Stop Many Smokers
December 11, 2006 - A new study has found that
close to half of 154 smokers who had surgery to remove early stage lung
cancer picked up a cigarette again within 12 months of their potentially
curative operation, and more than one-third were smoking at the one year
mark. Sixty percent of patients who started smoking again did so within
two months of surgery.
The study, led by researchers at Washington
University School of Medicine and published in the December issue of
Cancer Epidemiology Biomarkers & Prevention, is the first to look at
smoking relapse among people who were "forced" to quit due to impending
surgery.
"These patients are all addicted, so you cannot
assume they will easily change their behavior simply because they have
dodged this particular bullet," said the study’s lead author, Mark S.
Walker, Ph.D., a clinical psychologist and Assistant Professor of
Medicine at Washington University. "Their choices are driven by
insidious cravings for nicotine."
The investigators found that those smokers who were
the last to give up their cigarettes - some on the same day as their
operation - and who saw smoking as a pleasurable activity they would
have difficulty giving up, were also the first to resume the habit.
And they concluded that patients who were able to
hold out the longest before they took up a cigarette after surgery were
the ones who were most likely not to be smoking in a year’s time.
"The results suggest that patients who wait until
cancer surgery to quit smoking need assistance from the medical
community to help them stay away from cigarettes, and that this
intervention should begin as soon as possible after treatment," Walker
said. No such programs are currently offered to lung cancer surgery
patients, he added.
At least seven studies of non-small cell lung
cancer patients have shown that many of these patients continue smoking
despite the risk, but the rate of relapse ranged from a low of 13
percent to about 60 percent.
This study was unique in that it sought to include
patients believed to be highly dependent on nicotine - so it included
only patients who smoked within three months of their diagnosis - and it
attempted to use saliva samples as well as questionnaires to gauge
whether patients were smoking 3, 6, and 12 months after surgery.
Investigators at Washington University and at the
University of Texas M.D. Anderson Cancer Center enrolled 154 patients
being treated for early stage lung cancer at their centers. These
patients were lucky, Walker said. "Their cancer was discovered largely
by accident when they were being examined for other medical conditions,
and so was potentially curable by surgery," he said. "More than
two-thirds of lung cancer is diagnosed at later stages in people with
symptoms, and treatment is much less successful."
The researchers found that 43 percent of patients
smoked at some point after surgery and 37 percent were smoking 12 months
after their operation.
Consistent with previous research, the
investigators hypothesized that greater nicotine dependence, a younger
age, lower income, and a lower level of education would be associated
with a greater likelihood of smoking post surgery.
But that is not what they saw on two of the four
variables. Instead, researchers found no link between the quantity of
smoking and the ability to quit, and they also were surprised to
discover that higher education was associated with a greater likelihood
of smoking after surgery.
"It wasn’t the number of cigarettes smoked daily
that determined who couldn’t quit, but how long they continued to smoke
before surgery. About half of the patients studied smoked within two
weeks of their operation," Walker says. "We are not certain what to make
of the finding about education, because no other study about smoking
cessation has reached that conclusion."
How long patients quit before surgery may have been
influenced by their "self efficacy" for quitting, he says. "The thing
that really drove whether or not people relapsed is whether they saw
smoking as pleasurable and rewarding to the point that they can’t do
without cigarettes, and they don’t believe they are able to quit."
Patients who were able to quit by the one year mark
waited longer to attempt to smoke again, or never began again. In fact,
more than one in four patients who smoked after surgery were nonsmokers
at the 12-month follow-up, he said. "Perhaps for these patients, lung
cancer surgery was a wake-up call to quit, but many others need
intervention to help them fight nicotine."
Editor's Notes
The study was funded by grants from the National
Institutes of Health.
The mission of the American Association for Cancer
Research is to prevent and cure cancer. Founded in 1907, AACR is the
world's oldest and largest professional organization dedicated to
advancing cancer research. The membership includes more than 24,000
basic, translational, and clinical researchers; health care
professionals; and cancer survivors and advocates in the United States
and more than 70 other countries.
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