The Need to Prioritize and Re-prioritize Palliative Care Options: Smoking Cessation as a Case-in-Point
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Palliative care in cancer patients requires a continuous reprioritization of effort. This review describes the need for this reprioritization and uses smoking cessation as a case-in-point. The treatment of patients with metastatic non-small cell lung cancer has changed dramatically in the past few years. Interestingly, patients who had previously smoked now have an improved prognosis—for a variety of reasons. This review discusses this last observation in detail and raises the question of how forcefully we should advise smoking cessation in patients with incurable metastatic non-small cell lung cancer.
KeywordsPalliative care Smoking cessation Case-in-point
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Conflict of Interest
Konstantinos Leventakos, Anna J. Schwecke, Erin Deering, Elizabeth Cathcart-Rake, Anna C. Sanh, and Aminah Jatoi declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
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- 1.Fulton JJ, LeBlanc TW, Cutson TM, et al. Integrated outpatient palliative care for patients with advanced cancer: a systematic review and meta-analysis. Palliat Med. 2018:1–12.Google Scholar
- 5.https://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/stopping-tobacco-use-after-cancer-diagnosis; last accessed January 22, 2019.
- 8.Li C, Marek M, Guclu SZ, et al. Smoking and prognostic factors in an observational setting in patients with advanced non-small cell lung carcinoma. 2011; 2:52–62.Google Scholar
- 10.Desrichard A, Kuo F, Chowell D, et al. Tobacco smoking-associated alterations in the immune microenvironment of squamous cell carcinomas. J Natl Cancer Inst. 2018. 10.1093.Google Scholar
- 11••.Kim JH, Kim HS, Kim BJ. Prognostic value of smoking status in non-small cell lung cancer patients treated with immune checkpoint inhibitors: a meta-analysis. Oncotarget 2017; 8:93149–93193,155. This meta-analysis points out the relationship between smoking and outcomes in patients who are receiving PD-L1 inhibitors.Google Scholar
- 13•.Norum J, Nieder C. Tobacco smoking cessation and PD-L1 inhibitors in non-small cell lung cancer: a review of the literature. ESMO Open 2018; e000406. This paper points out the relationship between smoking and outcomes in patients who are receiving PD-L1 inhibitors.Google Scholar
- 16.https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/quitting/index.htm; last accessed January 22, 2019.