Smoking adds to woes of women with cervical cancer

  Article date: 2002/11/11,Habit May Complicate Radiation Therapy

Researchers at the MD Anderson Cancer Center were puzzled. They couldn’t explain why Hispanic women had fewer bowel complications when they were treated with radiation for cervical cancer than non-Hispanic white women.

So they began to look at more patients and other factors that might cause this difference, and they found it — smoking. Hispanic women didn’t smoke as much as non-Hispanic white women.

Along the way, Patricia J. Eifel, MD, and her radiation oncology colleagues also discovered other factors that contributed to complications in radiation therapy for cervical cancer. They reported their results in the Journal of Clinical Oncology (Vol. 20, No. 17: 3651-3657).

Cervical cancer will be diagnosed in about 13,000 women this year. Because it is usually detected early by pap smears and because modern treatment is effective, only about 4,100 women are expected to die of the disease in 2002. The usual treatment is either hysterectomy or radiation therapy to the pelvis by both external radiation and radiation implants.
Smoking Linked To Complications As Well As Cancer

Eifel studied nearly 3,500 patients who received radiation therapy for cervical cancer at MD Anderson. She looked specifically at women who had complications from the treatment.

Typical complications involve the intestine. Women may have severe cramps, diarrhea, and even intestinal blockage. The bladder can also be affected, causing severe burning and the need to urinate often.

The researchers found that women who smoked less than a pack a day had twice as many intestinal complications as non-smokers. Women who smoked more than a pack a day had three times as many complications.

Heavy smoking also increased bladder problems, although obesity was an even greater risk factor. African-American women in particular had a higher rate of bladder complications, which the doctors thought was mostly due to their higher rate of obesity.
Researchers Could Not Point To Reason

Although the lack of smoking partly explained the lower complication rate in Hispanic women, it didn’t completely explain it. In fact, the researchers were still puzzled. They also couldn’t explain how smoking caused these complications although it is known to have many different effects on intestinal function.

But the results of the study still held. Smokers had more problems with radiation treatment of the pelvis. Quitting didn’t seem to help. Smokers who said they quit still had problems although the researchers pointed out they may have gone back to smoking.

Clearly smoking is a major issue for cervical cancer, the authors said. It has become clear from many studies that smoking is a major risk factor for cervical cancer. Now, it seems, it also complicates its treatment, they concluded.

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