Avoid smoking and alcohol during head/neck cancer treatment

Avoid smoking and alcohol during head/neck cancer treatment

19 Mar 2015

Current smoking and heavy alcohol consumption appear to be risk factors for prolonged use of a gastrostomy tube (GT, feeding tube) in patients with head and neck cancer undergoing radiotherapy or chemoradiotherapy, according to a report published online by JAMA Otolaryngology-Head & Neck Surgery.

The insertion of a prophylactic GT before treatment is recommended as the toxic effects of chemoradiotherapy, a well-established treatment for advanced cancer of the head and neck, can compromise eating leading to weight loss and malnutrition.

Study-identified risk factors

Patrick Sheahan, M.B., M.D., F.R.C.S.I., of the South Infirmary Victoria University Hospital, Cork, Ireland, and coauthors studied smoking and alcohol consumption as potentially modifiable risk factors for increased duration of GT use.

The study included 104 patients at an academic teaching hospital with squamous cell cancer of the head and neck and undergoing treatment with either chemoradiation (84 patients) or radiotherapy alone (20 patients).

The authors found the median duration of GT use was 9 months, while 35% used GT for 12 months. Risk factors for prolonged GT use appeared to be:

• Current heavy alcohol consumption (someone who drank every day, drank more than a specified amount per week, or had a history of alcoholism or alcohol-related illness and was still drinking) and
• Current smoking, but only current smoking remained an independent risk factor in multivariable analyses, according to the results.

Why do smoking and drinking have such an adverse effect?

The authors speculate there are several reasons why smoking and drinking might have an effect, including that:

• nicotine may suppress appetite so patients make less of an effort to resume full eating by mouth and
• smoking and drinking may lead to poor patient motivation to resume eating after treatment.

"Our results would support advising patients with head and neck squamous cell carcinoma undergoing radiotherapy or chemoradiotherapy to avoid smoking and excess alcohol consumption during treatment. However, to determine whether stopping smoking and drinking can shorten duration of GT use will require further data from prospective studies," the study concludes.

Source: Science Daily