Cancer survivors still smoke and that doesn't really surprise me

Cancer survivors still smoke and that doesn't really surprise me
"Smoke," photo by Ferran Jordå. Used under a creative commons license:

The night before I went to the ER and was admitted to the hospital, where I was diagnosed with bladder cancer, I smoked my last cigarettes. That was more than two years ago.

During the first year, the thought of smoking was far from my mind. I had always loved the smell of a freshly lit cigarette outdoors, but in that first year I’d walk past a smoker and the smell would trigger tears.

Two years later I linger behind the guy walking in front of me, inhaling the smell of his freshly lit cigarette. I’ll probably always love that smell.

Who knows if smoking caused my cancer, but research tells me that it probably did. Certainly my doc thinks it did. He hasn’t asked me about it recently, but during the first few months after diagnosis, he frequently reminded me that people who continue smoking have a less positive response to treatment.

Recent research suggests that he and other docs should probably keep up the reminders. A study by the American Cancer Society shows that 10% of cancer survivors are smoking nine years after diagnosis. The vast majority of these smokers average 15 cigarettes per day. (An article in ClinicalOncology describes the results here.)

For me, the study hit home because bladder cancer survivors logged the highest rate at 17.2%.

Researchers and doctors should now study why people continue to smoke, in my opinion. Obviously addiction has a grip on smokers, and I don’t think people understand how strong that grip can be.

Cancer survivors face a cluster of effects in the years after treatment. From neuropathy and “chemo brain” to hearing loss and the loss of body parts, survivorship itself can be a challenge.

Treatments can ravage the body and turn active wage-earners into disabled people burdened by loss of income and massive medical bills.

Anxiety is an easily overlooked side effect of cancer.  While it is common, even expected, right after diagnosis and during treatment, anxiety lingers much longer for many of us. Cancer doesn’t just end.

As the New York Times reported here in July 2013, anxiety lingers for many years for both survivors and their families.

This particular side effect seems, to me, to be directly connected to continued smoking (or the return to smoking) seen in cancer survivors.

I know for me that smoking was part of strategy of coping with stress, a trifecta of cigarettes, a glass of wine and time alone in my garage.

In the immediate aftermath of a cancer diagnosis, it was easy for me to set aside smoking. Abject fear and weekly visits to doctors were all the intervention I needed.

As time goes on, the trips to the doctor have stretched to every six months and fear has been transformed into confidence. But that spiral of anxiety in my stomach is still there.

Oddly, as life returns to normal, the addictive behavior that caused me to veer off the road in the first place, seems more inviting. The temptation to return to smoking is strong for me. I found comfort and enjoyment in those moments alone.

More research and attention is being paid to survivorship, and I hope doctors learn to embrace their continued responsibility to those of us whose cancer is in remission. I would love to see doctors give direct attention to survivors with regard to their emotional needs.

Just as orthopedic surgeons prescribe physical therapy to patients after surgery, I’d like to see my urologist recommend practitioners to tend to my emotional well-being.

I don’t expect my doc to counsel me, but I’d like to see him check in with me about anxiety and my coping skills. He should definitely be checking in with me about smoking.

Even if our doctors don’t, we need to take care of ourselves and find support for our continuing needs. If you don’t already belong to a support group, I encourage you to find one.

My goal for today is to make sure that I’m not one of the 17.2% who continue or return to smoking.

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Filed under: Smoking

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