Smoking and Exposure after a Diagnosis of Lung Cancer
My father was diagnosed with stage IIIB lung cancer and will be undergoing chemotherapy. He quit smoking about 3 years ago and so did his wife. There are other individuals in the household that smoke and feel it is all right to smoke in a different room or when he is not home. My question is: Is this thinking logical? Will the residue smoke and chemicals interfere with his treatments and/or make his condition worse?
Barbara Campling, MD, Medical Oncologist, responds:
Your father stopped smoking three years before the diagnosis of Stage IIIB lung cancer (presumably non-small cell lung cancer). It is now recognized that at least half of patients who are diagnosed with smoking-related lung cancers have stopped smoking prior to diagnosis. Sometimes they stop shortly before diagnosis, possibly because of symptoms brought on by the tumor, such as a worsening cough or trouble breathing with exertion. Others seem to stop before the onset of symptoms, sometimes without too much difficulty. We are now seeing lung cancer in patients who have stopped smoking even decades prior to diagnosis. We are trying to learn more about what causes lung cancer patients to stop smoking shortly before diagnosis. However, it has been clearly shown that patients with lung cancer (and other types of cancer as well) have a better outcome if they have stopped smoking prior to therapy. There are many reasons for this. Recent studies have shown that while nicotine, which is the addictive component of tobacco, is not directly carcinogenic (cancer-causing), it can indirectly promote the growth of cancer and interfere with the effectiveness of cancer treatments like chemotherapy.
You are concerned that your father's exposure to secondhand smoke may be detrimental. While exposure to secondhand smoke over a long period of time can be harmful, the exposure to nicotine in secondhand smoke is very small, and is unlikely to interfere with his treatment. You mentioned that the smokers in the house do not smoke in his presence, so the exposure to nicotine and harmful chemicals should be very minimal. The most important thing is to ensure that his exposure to smokers does not cause him to take up the habit again.