Does smoking interfere with chemotherapy?

Tigerette asked...

My husband has Esophageal cancer, was diagnosed Oct 9, 2008. He went through chemo for three months, then went through surgery, now he is on chemo and radiation, How long does a person with this kind of cancer survive? He is suffering badly. Also, because he went back to smoking for two months now, what does this do while taking chemo and radiation?

Expert Answer

Bonnie Bajorek Daneker is author and creator of the The Compassionate Caregiver's Series, which includes "The Compassionate Caregiver's Guide to Caring for Someone with Cancer," "The Journey of Grief," "Handbook on Hospice and Palliative Care," and other titles on cancer diagnosis and end of life. She speaks regularly at cancer research and support functions, including PANCAN and Cancer Survivor's Network. She is a former member of the Executive Committee of the CSN at St. Joseph's Hospital of Atlanta and the Georgia Chapter of the Lymphoma Research Foundation.

The American Cancer Society says that esophageal cancer's survival rates are "18% of white patients and 11% of African-American patients survive at least 5 years after diagnosis. These figures take into account all patients with esophageal cancer, no matter what stage they were in at diagnosis. Survival rates for early stage disease are higher." 

This means that most patients (82% white or 89% black) will not live past 5 years. You'll want to help him on a daily basis, but make sure you've had some long-term, end-of-life discussions, so that when that time comes, you will know what he'd like to do. 

You mention that he is suffering badly now, and I can understand why. He's had major treatments in a relatively short period of time. It seems like his oncologist is aggressively managing in the best way for his condition, which is very good.

While smoking has been proven harmful to the body -- and most health professionals advise against it -- there is little definitive research of the impact of smoking on chemo on esophageal cancer. In lung and other cancers, it has been shown to decrease the effectiveness of the chemotherapy agents and decrease overall healing in tissue.

Although you may not like that he's smoking again, he may do this for some relief, enjoyment or distraction.  While you cannot make him stop, let him know that he's acting contrary to his treatment goals. Understand if he needs to make the decision to continue doing so.