Association between tobacco use, pain expression, and maladaptive coping among patients with advanced cancer.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 65-65
Author(s):  
Rony Dev ◽  
Yu Jung Kim ◽  
Akhila Sunkepally Reddy ◽  
David Hui ◽  
Kimberson Cochien Tanco ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Tobacco Use ◽  
Symptom Expression ◽  
Advanced Cancer Patients ◽  
Maladaptive Coping ◽  
Increased Risk ◽  
Pain Expression ◽  
Former Smokers ◽  
Never Smokers

65 Background: Cancer patients who smoke have been reported to have higher pain expression and increased risk for opioid abuse. The purpose of our study is to evaluate the association between tobacco use, symptom expression, and maladaptive coping in advanced cancer patients. Methods: We prospectively enrolled advanced cancer patients evaluated in an outpatient Supportive Care Center and collected data on patient demographics, cancer diagnosis, morphine equivalent daily dose (MEDD), cigarette smoking status using Behavioral Risk Factor Surveillance System, symptom expression as measured by Edmonton Symptom Assessment Scale, Cut down/Annoyed/Guilty/Eye opener (CAGE alcoholism questionnaire), short form Screener and Opioid Assessment for Patients with Pain (SOAP-SF) survey, and Brief COPE Questionnaire. Results: Among399 patients, 195 (49%) were never smokers, 158 (40%) former smokers, and 46 (11%) current smokers. The most common malignancies were gastrointestinal (21.1%) and breast (19.5%). Never smokers were more likely to be female (p = 0.005). Current smokers expressed significantly higher pain scores at consultation than former or never smokers [median 7 vs. 6 vs. 5, respectively (p = 0.015)], increased MEDD (median 90 vs. 60 vs. 50, p = 0.002), and more likely to screen CAGE positive (33% vs. 24% vs. 8.7%, p < 0.0001). Compared with former and never smokers, current smokers were significantly more likely to cope with substance use (p = 0.02), denial (p = 0.007), and self-blame (< 0.0001), while both current and former smokers significantly more likely to use venting (p = 0.04). In addition, current smokers compared with former and never smokers were significantly more likely screen positive (≥ 4) on the SOAP-SF survey (74% vs. 13% vs. 9.3%, p = < 0.0001) and clinicians rated patients to be at higher risk for maladaptive coping (6.5% vs 2.5% vs. 1.5%, p = 0.003). Conclusions: In advanced cancer, current and former smokers were significantly more likely to have higher pain expression, CAGE positivity, and increased MEDD at consultation. In addition, a history of current or past tobacco use in advanced cancer patients was associated with increased risk of maladaptive coping.

Association between tobacco use and symptom expression, alcoholism, and illicit drug use in patients with advanced cancer.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 154-154
Author(s):  
YuJung Kim ◽  
Rony Dev ◽  
Akhila Sunkepally Reddy ◽  
David Hui ◽  
Gary B. Chisholm ◽  
...  
Keyword(s):  
Drug Use ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Advanced Cancer Patients ◽  
Pain Expression ◽  
History Of ◽  
Former Smokers ◽  
Never Smokers

154 Background: Our aim was to determine the association between smoking status and symptom expression, opioid use, alcoholism, and illicit drug use in advanced cancer patients. Methods: We retrospectively reviewed 560 consecutive charts from the outpatient Supportive Care Center and identified 300 advanced cancer patients who completed a comprehensive smoking questionnaire. Data on the Edmonton Symptom Assessment Scale (ESAS), morphine equivalent daily dose (MEDD), CAGE (Cut Down, Annoyed, Guilty, Eye Opener) questionnaire for alcoholism screening, and history of illicit drug use were collected. Results: Among 300 advanced cancer patients, 119 (40%) were never-smokers, 148 (49%) were former smokers, and 33 (11%) were current smokers. Compared with never-smokers, current smokers were more likely to be men (58% vs. 29%, P=0.004), report a higher pain expression (median 7.0 vs. 5.0 by the ESAS, P=0.007), be CAGE positive (≥2 yes response) (42% vs. 3%, P<0.001), and have a history of illicit drug use (33% vs. 3%, P<0.001). Compared with never-smokers, former smokers were more likely to be men (60% vs. 29%, P<0.001), have head and neck cancer or lung cancer (30% vs. 13%, P=0.001), be CAGE positive (21% vs. 3%, P<0.001), and have a history of illicit drug use (16% vs. 3%, P<0.001). Current smokers reported a higher pain expression than former smokers (median 7.0 vs. 6.0 by the ESAS, P=0.01), had higher CAGE positivity (42% vs. 21%, P=0.01) and more frequent illicit drug use (33% vs. 16%, P=0.03). The MEDD and the timing of palliative care referral were not significantly different between current or former smokers compared with never-smokers. However, a higher proportion of current smokers were receiving opioids with MEDD ≥30mg at the time of palliative care consultation compared with never-smokers (70% vs. 52%, P=0.08). Conclusions: Our study suggests that current tobacco use is associated with a higher pain expression. In addition, any history of tobacco use is associated with a history of illicit drug use and alcoholism. Advanced cancer patients who smoked cigarettes may be at an increased risk for chemical coping or stronger opioid utilization and further studies are needed.

Symptom expression in advanced cancer patients admitted to hospice or home care with and without delirium

2018 ◽  
Vol 14 (4) ◽  
pp. 515-520 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Francesco Masedu ◽  
Marco Maltoni ◽  
Daniela De Giovanni ◽  
Luigi Montanari ◽  
...  
Keyword(s):  
Home Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Symptom Expression ◽  
Advanced Cancer Patients

scholarly journals Tobacco Use and Incidence of Tooth Loss among US Male Health Professionals

2007 ◽  
Vol 86 (4) ◽  
pp. 373-377 ◽  
Author(s):  
T. Dietrich ◽  
N.N. Maserejian ◽  
K.J. Joshipura ◽  
E.A. Krall ◽  
R.I. Garcia
Keyword(s):  
Tobacco Use ◽  
Health Professionals ◽  
Tooth Loss ◽  
Time Dependent ◽  
Cox Models ◽  
Male Health ◽  
Increased Risk ◽  
Former Smokers ◽  
Never Smokers ◽  
Dose Dependent

Data on the dose-dependent effects of smoking and smoking cessation on tooth loss are scarce. We hypothesized that smoking has both dose- and time-dependent effects on tooth loss incidence. We used longitudinal data on tobacco use and incident tooth loss in 43,112 male health professionals, between 1986 and 2002. In multivariate Cox models, current smokers of 5 to 14 and 45+ cigarettes daily had a two-fold (HR, 1.94; 95% CI, 1.72, 2.18) and three-fold (HR, 3.05; 95% CI, 2.38, 3.90) higher risk of tooth loss, respectively, compared with never-smokers. Risk decreased with increasing time since cessation, but remained elevated by 20% (95% CI, 16%, 25%) for men who had quit 10+ years before. Current pipe/cigar smokers had a 20% (95% CI, 1.11, 1.30) increased risk of tooth loss compared with never- and former smokers of pipes/cigars.

Association of body mass index (BMI) with clinical efficacy of immune checkpoint inhibitors (ICI) in advanced cancer patients: A retrospective analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e15066-e15066
Author(s):  
Raphael Brandao Moreira ◽  
Mauricio Fernandes ◽  
Mariana Ribeiro Monteiro ◽  
Francine Luiz ◽  
Erika Simplicio ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Clinical Efficacy ◽  
Objective Response ◽  
Obese Group ◽  
Secondary Outcome ◽  
Advanced Cancer Patients ◽  
Primary Tumor Site ◽  
Increased Risk ◽  
Risk Of Cancer

e15066 Background: Obesity is linked to an increased risk of cancer development. The excess of body fatness seems to be associated with alterations in hormonal, metabolic and inflammatory pathways, that may lead to activation of the carcinogenesis process. Previous studies suggested this obesity pro-inflammatory state could improve ICI clinical efficacy. Methods: Baseline characteristics and clinical outcomes were retrospectively collected from advanced cancer patients of any primary site, and treated with ICI in our institution. The BMI was determined for all pts and categorized into 2 groups: obese (BMI≥30) and non-obese (BMI < 30). Primary outcomes were the association of BMI category with overall survival (OS) and progression free survival (PFS) assessed by log-rank statistic, and both were stratified by sex, age, treatment agent and primary tumor site using the Cox-regression. Secondary outcome was the association of BMI with objective response rate (ORR). Results: We collected data from 448 advanced cancer pts - 192 (43%) as normal weight, 159 (36%) as overweight, 78 (17%) as obese and 19 (4%) as underweight. A total of 370 pts (83%) were included in the non-obese group (BMI < 30) and 78 (17%) patients in the obese group (BMI≥30). The majority of pts (387 - 84%) received anti-PD-1/anti-PD-L1; 128 pts (28%) were treated at 1st line and 200 pts (44%) at 2nd line. The obese group experienced longer mOS than the non-obese group - 21.8 months (95% CI NR - NR) vs. 14.9 months (95% CI 8.3 -21.5); HR = 0.82, (95% CI 0.57-1.18, P = 0.28). However, this was not statistically significant and even after stratification. The obese group had an inferior mPFS than the non-obese group - 4.7 months (95% CI 3.8- 5.7) vs. 5.3 months (95% CI 3.45-7.15); - HR = 0.99, (95% CI 0.76 -1.30), P = 0.95. There was no significative difference in mPFS and ORR according to BMI. Conclusions: Although study did not report an improved OS among high BMI pts treated with ICI, our results suggested a trend in survival benefit. The BMI should be explored as a stratification variable in the design of prospective trials with advanced cancer pts and ICI treatment.

The Role of Religiosity in Symptom Expression of Advanced Cancer Patients

2021 ◽  
pp. 104990912110413
Author(s):  
Sebastiano Mercadante ◽  
Claudio Adile ◽  
Marianna Ricci ◽  
Marco Maltoni ◽  
Giuseppe Bonanno ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Social Relationship ◽  
Karnofsky Performance Status ◽  
Depression Scale ◽  
Symptom Expression ◽  
Advanced Cancer Patients ◽  
Edmonton Symptom Assessment Scale ◽  
Relevant Role

Aim: The aim of this study was to assess the religious pattern and its impact on symptom expression in patients with advanced cancer. Methods: A consecutive sample of advanced cancer patients screened at admission to palliative care. Standard epidemiological data were recorded. Patients were asked about their religious beliefs, the degree of social relationship to existing religions, the role of religion in their life, and the frequency of their prayer. The Edmonton Symptom Assessment Scale (ESAS) and Hospital Anxiety Depression scale (HADS) were assessed. Results: Two-hundred-eighty-three patients were screened. Age and gender were found to be independently correlated with religious belief (p = 0.042 and p = 0.016, respectively). Gender (females, p = 0.026), age (p = 0.003), lower Karnofsky performance status (KPS) (p = 0.022), and higher values of HADS-A (p = 0.003) were independently correlated with the degree of social relationship to existing religions. Gender (females, p = 0.002), lower KPS (p = 0.005), and higher values of HADS-A (p = 0.04) were independently correlated with a more relevant role of religiosity. Gender (females, p < 0.0005), lower KPS (p = 0.001), and drowsiness (p = 0.05) were independently correlated with frequency of prayer. Conclusion: The more the patients have demanding religious issues, the greater the state of anxiety, particularly in older and female patients with a lower KPS. The religious pattern did not have relevant role in the expression of other symptoms included in the ESAS.

Smoking and Hodgkin Lymphoma: A Meta-Analysis

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4829-4829
Author(s):  
Sheila Pascual ◽  
Cannon Milani ◽  
Joanna Mitri ◽  
Jorge Castillo
Keyword(s):  
Hodgkin Lymphoma ◽  
Tobacco Use ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Control ◽  
Current Smoker ◽  
Case Control Studies ◽  
Increased Risk ◽  
Former Smokers ◽  
Never Smokers

Abstract INTRODUCTION: The etiology of Hodgkin lymphoma (HL) is largely unknown. However, certain associations have been noted, such as familial factors and infection with viruses. Smoking has been associated with the development of multiple malignancies and some studies have reported an association between HL and smoking but the relationship of tobacco use with lymphomas in largely unclear. OBJECTIVE: To investigate the potential relationship between tobacco use and the development of HL using a meta-analysis methodology of retrospective, case-control studies. METHODS: An extensive search was conducted using Pubmed/MEDLINE through July 2008. Case-control studies that reported odds ratio (OR) and 95% confidence intervals (CI) or allow for those values to be calculated were included in our analysis. Case reports, editorials, letters to the editor, review articles and prospective studies were excluded. The smoking status was then subdivided in three groups: never smokers, former smokers and current smokers. Meta-analyses were performed comparing the risks of former and current smokers against the risk of never smokers of developing HL. Fixed and random effects models were used to assess for heterogeneity. RESULTS: Seven case-controls studies, accounting for 3201 cases and 15268 controls were included in the analysis. Most of the articles reported OR adjusted for age, sex and educational level. In former smokers, the OR was 0.73 (95% CI, 0.65 – 0.82) when compared to never smokers; no heterogeneity was detected. The current smoker group had an OR of 1.70 (95% CI, 1.36 – 2.13) when compared to the never smoker group; some heterogeneity was detected in this group (p &lt; 0.003, I2 = 69.6%). CONCLUSIONS: Despite the heterogeneity observed in the analysis, the current smoker group seems to have a 70% increased risk of developing HL. Although a cause-effect linkage between tobacco use and HL is difficult to prove, further basic and translational research is necessary to clarify the potential etiological role of smoking in HL.

Financial distress and its impact on symptom expression in advanced cancer patients

2020 ◽  
Vol 29 (1) ◽  
pp. 485-490 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Federica Aielli ◽  
Claudio Adile ◽  
Giuseppe Bonanno ◽  
Alessandra Casuccio
Keyword(s):  
Cancer Patients ◽  
Advanced Cancer ◽  
Financial Distress ◽  
Symptom Expression ◽  
Advanced Cancer Patients
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