Smoking doubles complication risk after cervical cancer treatment

  The risk of serious gastrointestinal (GI) tract complications is almost doubled if they are also hea

For patients treated with radiation therapy for cervical cancer, the risk of serious gastrointestinal (GI) tract complications is almost doubled if they are also heavy smokers. The finding was presented recently at the American Society for Therapeutic Radiology and Oncology (ASTRO) annual meeting in Boston.

Patricia Eifel, MD, professor of radiation oncology at M.D. Anderson Cancer Center in Houston, and her team examined data from 3,489 patients treated with radiation for invasive cervical cancer between 1960 and 1994. The researchers analyzed the data to learn if the risk of serious complications might be affected by age, race, smoking, or other personal characteristics. They found smoking had more influence on the risk of serious complications than any other factor.

The study found about 6.5% percent of all the patients ? smokers and non-smokers ? had serious GI complications within five years following radiation treatment for their cervical cancer. By 10 years after treatment, that increased to about 8%.

About 5.4% of non-smoking patients had serious GI complications but pack-a-day smokers had a 9% chance of having serious complications. Those smoking more than a pack a day had a 13% chance of serious GI complications.

The GI complications typically begin long after treatment and involve bleeding in the bowel, rectum, and bladder, according Eifel. She says scientists aren?t sure why smokers had up to double the likelihood of bleeding compared to non-smokers but notes that cigarette smoking is known to harm the blood vessels and may make them more sensitive to radiation.

An American Cancer Society (ACS) expert on cervical cancer says both patients and doctors should keep the results of this study in mind. "Doctors should proactively raise this question [of whether the patient smokes] with patients before treatment begins for cervical cancer so the patient and her medical team can be prepared to watch for and deal with the complications that may occur later," says Debbie Saslow, director of breast and cervical cancer programs for the ACS. "And the patient should tell her doctor about her smoking history, even if the doctor fails to ask."

Saslow notes that smoking not only raises the risk of complications after radiation treatment for cervical cancer, but also increases the chances that a woman will develop the disease in the first place.

To help lower risk of cervical cancer, Saslow suggests, "Like all women, those who smoke should have a Pap test once a year starting at age 18 or whenever they become sexually active, whichever comes first. This will help catch any precancerous changes in the cervix so those cells can be removed before they progress further. After three consecutive normal tests, the test can be done less often, at the discretion of her health care provider."

Saslow adds that women who smoke should call the ACS and take advantage of its services and programs to help them quit. "That will help reduce their risk of several other cancers as well," she says.

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