¿Los cigarrillos electrónicos son mejores que los cigarrillos combustibles para las personas con cáncer?
¿ Los cigarrillos electrónicos son seguros para las personas con cáncer? ¿Qué pasa si se están utilizando para ayudar a una persona a dejar de fumar? La investigación sobre los cigarrillos electrónicos todavía es joven, pero ¿qué sabemos sobre la nicotina y las toxinas en esta alternativa de fumar?
Comencemos hablando sobre cómo el cigarrillo puede afectar a las personas que ya tienen cáncer, cómo la nicotina por sí sola puede afectar a las personas con cáncer (ya que la nicotina se encuentra tanto en los cigarrillos electrónicos como en los cigarrillos normales), y si los cigarrillos electrónicos pueden desempeñar un papel en dejar de fumar tratamiento. En otras palabras, ¿los cigarrillos electrónicos pueden ser una alternativa más segura para una persona con cáncer que fuma pero tiene dificultades para dejar de fumar?
¿Cuáles son los riesgos de fumar cuando una persona tiene cáncer?
Sabemos que fumar cigarrillos puede causar muchas enfermedades, incluido el cáncer, pero ¿de qué manera afecta a alguien que ya tiene cáncer? En realidad, hay muchas maneras en que los cigarrillos pueden ser perjudiciales, incluyendo:
- Supervivencia del cáncer: fumar puede reducir la supervivencia con cáncer de pulmón y cáncer de próstata. Fumar reduce la supervivencia y aumenta el riesgo de recurrencia con el cáncer de colon.
- Supervivencia general: fumar entre las personas con cáncer aumenta el riesgo de muerte por causas no relacionadas con el cáncer.
- Cirugía – Fumar aumenta el riesgo de complicaciones de la cirugía, como llevar a una curación tardía y un mayor riesgo de coágulos de sangre.
- Radioterapia: la radioterapia no parece ser tan efectiva para las personas que fuman. Fumar también puede aumentar el riesgo de efectos secundarios inducidos por la radiación (como la neumonitis por radiación) y puede funcionar junto con la radiación para aumentar el riesgo de cáncer secundario .
- Quimioterapia: fumar puede reducir la efectividad de la quimioterapia y también puede aumentar el riesgo de efectos secundarios y complicaciones relacionados con la quimioterapia. Al igual que con la radiación, la quimioterapia puede tener un riesgo adicional con el hábito de fumar, como con los medicamentos de quimioterapia que afectan al corazón.
- Targeted therapy – People who smoke may have poorer responses to treatment with targeted therapy drugs such as Tarceva (erlotinib) used for some people with lung cancer.
- Quality of life – Smoking can result in increased pain, worsened breathing, and greater fatigue for people with cancer.
- Relationships – Smoking increases the chance that a person with cancer will expose their loved ones to second-hand smoke.
- Financial – Smoking isn’t cheap, and adds to the significant costs already associated with cancer.
Learn more about the important reasons to quit smoking if you have cancer.
Are E-Cigarettes Safer Than Cigarettes for People With Cancer?
It seems pretty clear that smoking is a bad idea for people with cancer, but a few questions remain. Are e-cigarettes safer than regular cigarettes for people with cancer, and can the use of e-cigarettes help people give up smoking?
Certainly, e-cigarettes might spare people the exposure to tar and some of the multitude of chemicals in cigarette smoke (some e-cigarettes have been found to have formaldehyde as well as heavy metals) but they usually contain nicotine. So what do we know about nicotine in people with cancer?
What Is the Effect of Nicotine on People With Cancer?
There has been a debate on whether nicotine can cause cancer, but there is evidence that nicotine may be involved in the progression of cancer. Findings with different cancers looking at this question from different angles have found that:
- Nicotine might promote tumor progression in smoking-related cancers.
- Nicotine improved the survival of colon cancer cells exposed to chemotherapy.
- Sensitization of epithelial growth factor receptors by nicotine may promote the growth of breast cancer cells.
- Nicotine appears to promote tumor progression in some molecular types of pancreatic cancers. Nicotine was also found to promote the aggressiveness of pancreatic cancer in mice.
It’s thought that nicotine may promote cancer due to its ability to damage DNA, disrupt metabolic processes in the cell, and by fueling the growth and spread of cancer cells.
Nicotine may not only influence the growth of cancer but interfere with the treatments of cancer as well. For example, nicotine was found to promote resistance to the chemotherapy drug Platinol (cisplatin) in lung cancer cells, a treatment which is part of most chemotherapy regimens for the disease.
Nicotine and Toxins in E-Cigarettes vs. Nicotine Replacement Therapy
If we were able to compare the amount of nicotine in cigarettes with that in e-cigarettes and nicotine replacement therapy products, we may have some idea on how this risk would compare.
Unfortunately, since e-cigarettes were not regulated by the FDA until August 8, 2016, we have not known about the amount of nicotine present in these products. In contrast, pharmaceutical grade nicotine is used in all nicotine replacement therapy products in the United States such as nicotine patches, gum, inhalers, lozenges, or nasal spray.
A 2017 study in the Annals of Internal Medicine found that long-term use of e-cigarettes and nicotine replacement therapy resulted in nicotine levels similar to those of people who smoke combustible cigarettes. Both long-term users of e-cigarettes and long-term users of nicotine replacement products had substantially reduced levels of carcinogens and toxins that can be measured than those who smoked regular cigarettes. Those who combined e-cigarettes with nicotine replacement therapy, and those who smoked regular cigarettes along with e-cigs or NRP, however, had levels of these toxins similar to those of people who smoked regular cigarettes. Again, since e-cigarettes haven’t been regulated, we can’t know if the nicotine level in the e-cigarettes used in this study or the levels of toxins or carcinogens would be the same for another type or brand of e-cigarettes.
Other concerns remain. For example, one study found that a particular type of e-cigarette increased carbon monoxide levels in the blood. Whether this is common, how it compares to carbon monoxide from combustible cigarettes, and what this may mean for people with cancer isn’t yet known.
Do E-Cigarettes Help People Quit Smoking?
The jury is out as well on the role e-cigarettes may have as a smoking cessation product but at the current time, many experts believe that e-cigarettes should be considered a tobacco substitute and not a quit aid.
Do E-Cigarettes Cause Cancer?
A question that many people may be asking at this point is whether e-cigarettes can cause cancer. If you are living with cancer, the first concern is the role that e-cigs may play in the progression of cancer. As noted with nicotine above, we are still uncertain whether it can cause cancer to begin, but many studies tell us that it may contribute to the progression of a cancer already present.
At the current time, we don’t know exactly what effect e-cigarettes may have on the causation of cancer. it is simply too early to know. We do know that some e-cigarettes contain chemicals known to cause cancer.
Unfortunately, it took far too many years until the public was aware that there was a relationship between cigarette smoking and cancer. Part of the reason for this, as well as the reason we cannot yet know about the risk of e-cigarettes, comes down to the latency period. The latency period is defined as the amount of time between exposure to a substance and the development of cancer. With cigarette smoking, the average minimal latency period is usually around 30 years. For some substances (for example, the radiation exposure in Hiroshima) the latency period is shorter. For other substances, the latency period is longer. and for some substances, it is longer. Since e-cigarettes have only been available in the United States since 2006, we may have to wait a long time for this data.
Bottom Line on E-Cigarettes for People With Cancer
E-cigarettes may be somewhat safer than regular cigarettes for people with cancer, but still, carry risks due to the presence of nicotine. Several studies have found that nicotine alone may contribute to the progression of cancer.
If you or a loved one are seriously motivated to give up smoking due to having cancer, the best choice would be to use a quit aid combined with counseling and support. Unfortunately, far too many people transfer their addiction from regular cigarettes to e-cigarettes and never truly give up the habit.
It could be argued that e-cigarettes might be better from someone who would otherwise continue to smoke, but even the fact that you are reading this page shows that you have some motivation to improve your health, and response to cancer treatment.
In the near future, we are likely to learn more about the effectiveness of e-cigarettes in smoking cessation, and whether e-cigarettes should be contenders along with nicotine replacement products to assist with smoking cessation.
Quitting Smoking If You Have Cancer
There are clearly many benefits to quitting smoking if you have cancer, not just with regard to survival or quality of life, but concerning your response to nearly every type of cancer treatment. It could easily be argued that smoking cessation should be considered an integral part of your treatment, no less important than treatments such as chemotherapy or radiation.
There are few things less important than taking an honest and heartfelt look at how you can quit. Begin by learning the steps to take to ensure success when you quit. Then consider the wide range of quit aids available which can sometimes ease the discomfort of quitting. Then set your quit date.
Quitting is most successful when you don’t have to do it alone. Consider the people in your life who could be your cheerleaders. Is there someone you can be accountable to who you respect, perhaps even a friend or family member who has kicked the habit in the past? Foster a mindset that will help you quit for good.
I am Dr. Christopher Loynes and I specialize in Bone Marrow Transplantation, Hematologic Neoplasms, and Leukemia. I graduated from the American University of Beirut, Beirut. I work at New York Bone Marrow Transplantation
Hospital and Hematologic Neoplasms. I am also the Faculty of Medicine at the American University of New York.