It’s never too late to quit smoking before lung surgery

(Reuters Health) – Smokers who’ll be having surgery for lung cancer should quit smoking before the operation, and the sooner the better, a new study shows.

Among patients who had surgery for lung cancer, nonsmokers had fewer complications than smokers. But quitting even just a few months before surgery reduced patients’ risks of complications.

“Even a short period of four weeks of preoperative cessation may contribute to a major risk reduction,” said Dr. David Lindstrom of Uppsala Academic Hospital in Sweden, who wasn’t involved with the new study.

Nearly 230,000 new cases of lung cancer will be diagnosed in the U.S. in 2019, the American Cancer Society estimates.

Previous studies indicate that about a third of patients are current smokers at the time of diagnosis, and 20 percent are current smokers at the time of surgery, Mariko Fukui and colleagues at the Juntendo University School of Medicine in Tokyo wrote in their report of the study in Annals of Thoracic Surgery.

The researchers studied 666 patients who had surgery for lung cancer between 2012-2016, including 256 never-smokers and 410 current or previous smokers.

During the three months following the operations, about 32 percent of current smokers had respiratory complications, as compared to 22 percent of previous smokers and 3.5 percent of non-smokers. Generally, smokers were older, had poorer lung function, needed longer operations, and lost more blood during surgery.

The more time that elapsed since smokers had quit, the lower their risk of postoperative problems. Complication rates were 13 percent for current smokers, 10 percent for patients who stopped smoking less than a month before surgery, 8.5 percent for people who quit one to three months before surgery, 6.3 percent for three to six months, six percent for six months to a year, and five percent for former smokers who had quit more than a year before their surgery.

“Lung surgery outcomes are not only linked to long-term survival but to quality of life, and lung resection and lung cancer tend to decrease both of them,” said Dr. Maria Rodriguez Perez of Clinica Universidad de Navarra in Madrid, Spain, who researches lung cancer and surgery outcomes but wasn’t involved in this study.

“Nowadays, we tend to look at the patient as a whole, focusing not only on the specific pathology but on other systems that interact and could have a detrimental effect on outcomes,” she told Reuters Health by email. “Smoking cessation should be, without a doubt, one of the pillars of these programs.”

Lindstrom added, “It’s never too late to stop smoking. Even if the previous smoking history may have caused cancer, you may still benefit from decreased risk of surgical complications and have an increased life expectancy if you stop.”

“Any kind of forthcoming surgical procedure is a good time to try to stop smoking,” said Lindstrom, who has studied the effect of smoking cessation on outcomes of orthopedic surgery. “And when you decide to deal with it, take all the help you can get with motivational counseling, websites, apps and professionals.”

SOURCE: bit.ly/2SVCIf5 Annals of Thoracic Surgery, online January 2, 2019.