FINDING THE RIGHT FIT
Cancer patients who smoke find help quitting or cutting back at the JCC Retail Pharmacy
Choosing the right medication to help quit smoking is a lot like shoe shopping. For a comfortable experience, it’s essential to find the right fit.
“Patients often assume that nicotine gum or the patch are their only options,” says Anatoli Chkaroubo, staff pharmacist at the Juravinski Cancer Centre (JCC) Retail Pharmacy. “They may have tried those medications years ago and weren’t successful, or they may feel that a different product would work better for them. My role is to help patients explore their options, so they find the support they need to give up tobacco in preparation for their cancer treatment and recovery.”
Anatoli is a champion for JCC’s Tobacco Dependence Intervention (TDI) Program, which follows the evidence-based Ask, Advise, Act approach for supporting new cancer patients who use tobacco. `Ask’ involves talking to new cancer patients about tobacco use. `Advising’ is informing them about the many benefits of quitting. `Act’ is referring them to services such as the JCC Retail Pharmacy for medication to help quit and Smokers’ Helpline for support.
Quitting is the best thing patients can do to help their cancer treatment work better, whether they’re having surgery, radiation treatment or chemotherapy. People who quit are less likely to have infections or complications during or after surgery. Quitting helps radiation therapy work better and may reduce side effects. Quitting also helps chemotherapy drugs work better since cigarette smoke has chemicals that can lower the amount of some chemo drugs in the blood, making them less effective. Quitting also lowers the chance of a patient’s cancer coming back or getting another kind of cancer. In some situations, the benefit of quitting may even exceed the value of state-of-the-art cancer therapies.
Nicotine Replacement Therapy (NRT) comes in many forms including patches, gum, lozenges, mouth spray, and inhalers. Using NRT can double a person’s chances of quitting by reducing nicotine cravings and withdrawal symptoms. Two non-nicotine prescription medications are also available to help reduce cravings and prevent relapse – Champix and Zyban. Recent studies suggest that combining certain medications can also help people in their effort to quit.
“Our team works with patients to find the best fit and is always respectful,” says Anatoli. “We never push.” For some patients, receiving a cancer diagnosis or change in their prognosis is strong motivation to give up tobacco. But for others, dealing with cancer can make quitting especially challenging because it’s their stress reliever. “We can explore patients’ immediate and future goals and make a plan for quitting or cutting back,” says Anatoli.
“For example, if their goal is to get through a day of cancer treatment with NRT support so they don’t need a smoke break, we can help with that. And perhaps if they can get through a treatment session without smoking, they’ll see their potential to cut back even more.”
Tobacco use increases the risk of almost 20 different types of cancer and contributes to 30 percent of all cancer deaths and up to 90 percent of lung cancer deaths, says Cancer Care Ontario. One in five new cancer patients coming to an Ontario cancer centre are current or recent tobacco users.
Provincially, tobacco use continues to be the most common modifiable risk factor for cancer and other chronic diseases. Evidence suggests that the risk of dying could be lowered by 30 to 40 percent by quitting smoking at the time of diagnosis, says Cancer Care Ontario.