October 29, 2007

An Unexpected Finding: Smoking Is Not Associated with Advanced Breast Cancer?

Most people know that smoking causes cancer, emphysema, and heart disease. It can shorten a smoker’s life by up to ten years; moreover, the habit can cost the smoker (as seen in the image to the left) thousands of dollars a year. Nonetheless, investigators have found no difference in the breast cancer death rate among smokers and non-smokers, a fact that only few know. At Fox Chase Cancer Center in Philadelphia, researchers analyzed data on 6,162 women with breast cancer who were evaluated at the facility between 1970 and 2006. When they were first seen, 9% of breast cancer patients were smokers. One of the researchers at the center, Dr. Matthew Abramowitz, claimed, “For patients who developed breast cancer, there did not appear to be a difference in the cancers that they presented with based on whether or not they had ever smoked.” Most had expected a more advanced stage in the tumor among smokers. Although this was not the case, the tobacco industry should not take the finding as good news.

Another study was recently published in the British Journal of Cancer. This case-control study looked at Swedish-born women aged 50-74 years whose invasive breast cancers were identified between October 1993 and March 1995. Examination of the patient’s smoking habits included the smoking time period, duration or intensity, and frequency. Other health factors such as family and genetic background, and obesity were also observed. Despite the consideration of all these aspects, the association between smoking and advanced breast cancer could not be made. Nevertheless, those who conducted this study did discover a greater risk in breast cancer for women who consume alcohol (refer to the image on the right). Cancer specialist Wendy Y. Chen stated, “The more alcohol consumed on a regular basis, the greater the risk.” Statistically speaking, “one drink a day raises the figure to 9.4 cases per 100.” The reason is that alcohol is responsible for changing the way in which the body metabolizes estrogen, and because the majority of breast cancers are “fueled by the hormone estrogen,” higher consumption of alcohol contributes to higher blood estrogen levels. It should be noted that the relationship between smokers and the intake of alcohol is that smokers tend to drink more than nonsmokers. Since the level of alcohol is significant, the risk of the disease is higher.

The discovery that smoking does not have a considerable risk for breast cancer (though some researchers disagree) is an important yet surprising one. After much effort and time, anti-tobacco measures even gave up on the pursuit to link smoking with breast cancer. Is this good news for the tobacco industry? Not necessarily. Smoking does initiate the development of several other illnesses and diseases, including lung cancer, heart disease, and stroke. “Lung cancer has overtaken breast cancer as the leading cause of cancer deaths in women,” said Irma H. Russo, from Fox Chase Cancer Center. More importantly, heart disease is the number one cause of death among Americans. The discussion of the research in this post, therefore, does not justify the habit of smoking. Physicians will continue to warn their patients against unhealthy habits, especially when studies show that the association between smoking and breast cancer is “still somewhat controversial.” Even so, it will be interesting to see whether or not research will again disprove the current findings associated with smokers and advanced breast cancer in the future.


GA said...

With the last days of Breast Cancer Awareness Month, your post is both timely and thought provoking. Your links are well placed and lead to great resources. I was surprise to learn that “Researchers have found no difference in the breast cancer death rate among smokers and non-smokers”. You bring up a very interesting argument, which many I am sure would find very controversial. I think you did a great job of supporting your argument by including two research studies rather than just one. I also like the fact that you stated that just because smoking may “not [be] linked to aggressive breast cancer”, other drugs like alcohol can increase your risk. I feel that you may be able to strengthen your argument by introducing the positive correlation between alcohol and smoking a little earlier. This will allow readers to understand why just because smoking may not be a direct risk factor for breast cancer, it can indirectly increase other behaviors that can increase a women’s chance of developing this malicious chronic disease. I also enjoyed your concluding paragraph, which clarifies that “the discussion of the research findings in this post does not justify the habit of smoking”. I thought that was a crucial and well argued conclusion to your post. Even though smoking may not increase someone’s risk to develop breast cancer, it may lead to other dangerous health maladies including the number one killer, “heart disease”. Overall, I found your post, very informative and something that will be discussed and studied again by researchers in the future. I thought your images were well placed, although, I would have loved to see some of the statistical information from the two studies that you site in the form of an image. Great post jeh! I look forward to reading your work in the future.

KLF said...

First of all, I would like to say that I thought your post was interesting and brought to light an important new development in the understanding of cancer as well as the health risks of smoking. Although smoking cigarettes clearly has many health risks, I think many people are too quick to blame a person’s smoking as the cause of any illness they may develop. The studies you mention remind us that we must not jump to conclusions like this before having scientific evidence, because when the evidence is found, it will often contradict our assumptions. One thing I really liked about your post was the fact that you brought in several different studies, two about the link between cancer and smoking and one about its link with alcohol consumption, and brought them together. I thought this made your post into fascinating and complex discussion of the way some common bad habits can affect our health. One thing about your post that disappointed me was the fact that the link to the smoking and cancer study led me to a “Page Not Found.” However, I understand that many medical journals that contain studies such as that one require subscriptions. In the future, I would suggest that you provide two separate links, one to the abstract, which most journals usually provide for free, and one to the full text for those who have access to the journal. Your other links, however, were well done and definitely helped illuminate the topic. As a whole though, great post!

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