Smoking During Head & Neck Cancer Therapy Tied to Poor Outcome

Patients with head and neck cancer who continue to smoke while undergoing radiation treatments have a much lower long-term survival rate than those who kick the addiction, researchers have found. In the study of patients with squamous cell carcinoma of the head and neck, 23 percent of 101 patients who continued to smoke were still alive five years after treatment, compared with 55 percent of matched patients in a control group who quit smoking before they began radiation therapy.

In addition, 53 of the patients who continued to smoke suffered cancer recurrence, compared with 40 patients in the control group. The patients who kept smoking also had more treatment-related complications such as the development of scar tissue, hoarseness and difficulty eating. The poorer outcomes for persistent smokers were found both in patients who had radiation alone and in those who had surgery prior to radiation, the study authors noted in the report published in the February issue of the International Journal of Radiation Oncology/Biology/Physics.

"I've always told patients, 'You should really stop smoking,' but I had no tangible evidence to use to convince them that they would be worse off if they continued to smoke," lead author Dr. Allen Chen, residency training program director at the University of California, Davis, School of Medicine, said in a news release from the American Society for Radiation Oncology. "I wanted concrete data to see if smoking was detrimental in terms of curability, overall survival and tolerability of treatment. We showed continued smoking contributed to negative outcomes with regard to all of those," he added.

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Poor Health Habits Linked to Subpar Work Performance

People who engage in unhealthy habits such as smoking, eating a poor diet and not getting enough exercise turn out to be less productive on the job, new Dutch research shows. Unhealthy lifestyle choices also appear to translate into a greater need for sick leave and longer periods of time off from work when sick leave is taken, the study reveals. The finding is reported in the Sept. 28 online edition of the journal Occupational & Environmental Medicine.

"More than 10 percent of sick leave and the higher levels of productivity loss at work may be attributed to lifestyle behaviors and obesity," Alex Burdorf, of the department of public health at Erasmus Medical Center in Rotterdam, the Netherlands, and colleagues noted in a news release from the journal's publisher. Between 2005 and 2009, Burdorf and his associates surveyed more than 10,600 people who worked for 49 different companies in the Netherlands.

Participants were asked to discuss both lifestyle and work habits, rating their work productivity on a scale of 0 to 10, while offering information about their weight, height, health history and the number of days they had to call in sick during the prior year. The investigators found that 56 percent of those polled had taken off at least one day in the preceding year because of poor health. Being obese, smoking, and having poor diet and exercise habits were contributing factors in just over 10 percent of sick leave occurrences.

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Winter Sports Tourists at Higher Risk of Heart Attack

Skiers and other winter sports tourists who visit the Alps are at increased risk for heart attack due to low temperatures, high altitude and inadequate conditioning for intense physical exertion, finds a new study. The risk is greatest during the first two days of vacation, said a research team of cardiologists at the Medical University of Innsbruck, Austria, who focused on winter tourists in the Tyrolean Alps. "Every year, millions of tourists visit the Tyrolean Alps to participate in a variety of winter sports, each of which carries a certain risk of accident and injury," study senior author Dr. Bernhard Metzler, an associate professor of cardiology at the university, said in a news release from the European Society of Cardiology.

"Previously it had been shown that sudden cardiac death accounts for a staggering 40 percent of the total fatalities amongst winter sports tourists in the Austrian Alps and, of these, acute [heart attack] is the leading cause," he added. Metzler and colleagues analyzed data from 170 patients who suffered a heart attack during a winter sports vacation between 2006 and 2010. About 56 percent of the patients suffered their heart attack within the first two days of beginning intense physical activity, although just 19 percent had a known cardiac condition. Prior to their vacation, more than half of the patients got less than the minimum levels of physical activity recommended by the European Society of Cardiology.

Altitude may have been a major factor, the study authors noted. The patients' heart attacks occurred at a mean altitude of 1,350 meters (4,429 feet), compared to the mean altitude of 170 meters (557 feet) where they lived. The researchers also found that about 70 percent of the patients had at least two risk factors for coronary artery disease, including smoking, diabetes or high cholesterol levels. People planning winter sports holidays in the mountains need to prepare themselves with regular exercise beforehand, the study authors suggested. Once at the resort, they should increase their level of physical activity gradually, they added. The researchers presented their findings last week at the European Society of Cardiology Congress, in Stockholm, Sweden.

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Smoked Marijuana May Ease Chronic Nerve Pain

Smoking cannabis, also known as marijuana, reduced pain in patients with nerve pain stemming from injuries or surgical complications, new research shows. Twenty-one adults with chronic nerve pain were taught to take a single inhalation of 25 milligrams of cannabis through a pipe, three times a day, for five days. The cannabis contained one of three levels of potency of tetrahydrocannabinol (THC), the active ingredient in marijuana, as well as a placebo dosage containing no THC.All of the patients rotated through each of the four dosages, with nine days of no smoking in between. Patients smoking the highest potency marijuana reported less pain than those smoking samples containing no THC. Patients also reported better sleep and less anxiety, according to the Canadian study.

On an 11-point scale, the average daily pain intensity was 6.1 for those smoking 9.4 percent THC concentration, compared to 5.4 for those smoking cannabis containing no THC."Patients have repeatedly made claims that smoked cannabis helps to treat pain, but the issue for me had always been the lack of clinical research to support that claim," said Dr. Mark Ware, director of clinical research at the Alan Edwards Pain Management Unit of the McGill University Health Centre in Montreal. In this small but randomized, controlled trial, "the pain reductions were modest, but significant," he said. "And it was in people for whom nothing else worked."

The study is published in the Aug. 30 issue of the Canadian Medical Association Journal. Persistent nerve pain, clinically known as neuropathy, can be very difficult to treat, Ware said. These patients had tried other treatments for neuropathy, such as opioids, anticonvulsants, antidepressants and local anesthetics, with little relief, Ware said. In addition, the THC potency levels used in the study were kept at 2.5 percent, 6 percent and 9 percent considerably less than the 12 percent to 15 percent often found in marijuana sold on the street, Ware said. Researchers kept the levels low for two reasons, Ware explained. One was to minimize the psychoactive effects, such as feeling lightheaded, dizzy, detached, nauseous or euphoric.

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Study Finds Even a Little Cigarette Smoke Harms Airway

A drag from a cigarette now and then can't hurt, right? Wrong, according to a new study that finds even low levels of smoke exposure can cause irreparable damage to cells essential to breathing. The damage occurred among "casual" smokers and even after exposure to secondhand smoke. The initial damage, while not usually severe, can be cumulative and prolonged exposure to tobacco smoke could lead to chronic obstructive pulmonary disease (COPD) and even lung cancer, the researchers reported. "It has been known for a long time that secondhand smoke or smoking occasionally can be risky for your health," said study author Dr. Ronald Crystal.

Just how much a little exposure might damage airway cells hasn't been clear, however. "We found that if we could detect nicotine in the urine we could also detect changes in the genes in the cells lining the airways," said Crystal, who is also chair of the department of genetic medicine at Weill Cornell Medical College. The bottom line: "There is no level of cigarette smoking or exposure to cigarette smoke that does not make the cells in your lungs sick," he said. "If you are an occasional smoker you are still at risk. Don't think that smoking one or two cigarettes a week means you are home free."

As for secondhand smoke, "if you are working in a place where people smoke, either get them to stop or go get another job," Crystal advised. "If you have somebody at home who smokes, send them outside to smoke. Don't be exposed to secondhand smoke." The report is published in the Aug. 20 issue of American Journal of Respiratory and Critical Care Medicine. For the study, Crystal's team recruited 121 people who were nonsmokers, active smokers or low-exposure smokers. To determine who belonged in which group, all participants had their urine tested for levels of nicotine.

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Teen Survey Finds Gangs, Drugs Common in U.S. Schools

Drugs and gangs are common problems at public schools in the United States, a new teen survey shows.Among public school students aged 12 to 17, 27 percent (5.7 million) report that their schools are both "gang- and drug-infected." Drug-infected means that drugs are used, kept or sold on school grounds.The 15th annual teen survey by the National Center on Addiction and Substance Abuse at Columbia University also found that 46 percent of teens in public schools say there are gangs in their schools and 47 percent of teens say that drugs are used, kept or sold on school grounds.

Compared with teens who go to drug-free and gang-free schools, those at schools infected with both drugs and gangs are: five times more likely to smoke marijuana; three times more likely drink alcohol; 12 times more likely to smoke tobacco; three times more likely to have access to marijuana within an hour and five times more likely to have access to it within a day; and nearly five times more likely to know a peer who uses illegal drugs (such as acid, ecstasy, methamphetamine, cocaine or heroin). The complete survey findings were scheduled for release Thursday at a press conference at the Kaiser Family Foundation Building in Washington, D.C.

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