CHAPEL HILL, N.C. - Imagine that you are a doctor who treats cancer patients every day at a leading academic medical center. In the course of evaluating each patient, you ask them about their health behaviors and find that many of them – despite being diagnosed with cancer – are current smokers.
What do you do then? You’re not an expert in health behavior change or smoking cessation – how can you help your patients find the resources to quit at a time when they might have more incentive to do so than any other time in their lives?
That’s the scenario that many doctors, even those at National Cancer Institute member institutions, face according to Dr. Adam Goldstein, who presented findings from a national study he conducted regarding tobacco use treatment at National Cancer Institute (NCI) designated Cancer Centers.
“There is tremendous interest by the National Cancer Institute and institutions across the country in the work we’ve done at UNC to begin setting up model programs for smoking cessation, understanding what works, and learning from each other,” he says.
Goldstein notes that many people automatically assume that top-notch smoking cessation programs exist at nationally-known cancer centers – but they’re often wrong. The problem, he notes, is partially a result of a traditional division of responsibilities between primary care physicians and specialists.
A Family Medicine doctor himself, Goldstein notes, “Primary care doctors are trained to see smoking cessation counseling as part of their jobs, while oncologists and other cancer specialists see patients at a time where they are seeing the consequences of smoking in a cancer diagnosis. Delivering the news that someone has cancer and needs therapies that often have long recovery times and severe side effects is hard enough!”
“Oncologists are often reluctant to add another stressor – like smoking cessation – at such a difficult time. While this may seem like a reasonable concern, the cancer diagnosis motivates most patients to quit – creating a ‘teachable moment’. In addition, the outcomes of chemotherapy, radiation therapy and even surgery are much improved when patients quit smoking, which also lowers the risk of secondary or recurrent tumors.”
That’s why, he says, top cancer centers need to have effective smoking cessation programs in place and why the NCI has created a steering committee for Tobacco Use Treatment. Goldstein is a member of this steering committee, and recently presented the findings from a research project he and colleagues at UNC took on to determine what is being done at NCI-designated centers cross the country.
More than 100 attendees from more than 45 centers participated in the conference where Goldstein presented the data, resulting in several potential research collaborations.
“Thanks to the UCRF and UNC Lineberger funding for our national benchmarking project, UNC is able to help lead the field of tobacco use treatment and we are being consulted regarding the characteristics of model programs, funding options, mechanisms for informing cancer center staff about the importance of talking to patients about tobacco cessation and available resources and ongoing research about the effectiveness of these programs,” he said.