Smoking and Cancer

What is Cancer?

Cancer refers to diseases in which abnormal cells divide out of control and are able to invade other tissues. Cancer cells can spread to other parts of the body through the blood and lymph systems, which help the body get rid of toxins.1,2

There are more than 100 different types of cancer. Most cancers are named for the organ or type of cell in which they start—for example, lung cancer begins in the lung and laryngeal cancer begins in the larynx (voice box).1

Symptoms can include:3

  • A thickening or lump in any part of the body
  • Weight loss or gain with no known reason
  • A sore that does not heal
  • Hoarseness or a cough that does not go away
  • A hard time swallowing
  • Discomfort after eating
  • Changes in bowel or bladder habits
  • Unusual bleeding or discharge
  • Feeling weak or very tired

How Is Smoking Related to Cancer?

Smoking can cause cancer and then block your body from fighting it:4

  • Poisons in cigarette smoke can weaken the body’s immune system, making it harder to kill cancer cells. When this happens, cancer cells keep growing without being stopped.
  • Poisons in tobacco smoke can damage or change a cell’s DNA. DNA is the cell’s “instruction manual” that controls a cell’s normal growth and function. When DNA is damaged, a cell can begin growing out of control and create a cancer tumor.

Doctors have known for years that smoking causes most lung cancers. It’s still true today, when nearly 9 out of 10 lung cancers deaths are caused by smoking cigarettes or secondhand smoke exposure.5 In fact, smokers have a greater risk for lung cancer today than they did in 1964, even though they smoke fewer cigarettes. One reason may be changes in how cigarettes are made and what chemicals they contain.5

Treatments are getting better, but lung cancer still kills more men and women than any other type of cancer. In the United States, more than 7,300 nonsmokers die each year from lung cancer caused by secondhand smoke.6 Secondhand smoke is the combination of smoke from the burning end of a cigarette and the smoke breathed out by someone smoking.6

Smoking can cause cancer almost anywhere in your body, including the:5

Men with prostate cancer who smoke may be more likely to die from prostate cancer than nonsmokers.5

Smokeless tobacco, such as chewing tobacco, also causes cancer, including cancers of the:7

Terrie
Meet Terrie

Terrie smoked for 30 years.

“I’ve been diagnosed with cancer 10 times. I started smoking early. So much of what I’ve gone through — all these cancers — could have been prevented.”


Real stories about cancer:

Real Stories about cancer
Today I start my quit journey. Free resources provided by smokefree.gov

How Can Smoking-Related Cancers Be Prevented?

The most important thing you can do to prevent smoking-related cancer is not to smoke cigarettes, or to quit if you do. It is also important to avoid secondhand smoke.

Quitting smoking lowers the risk for 12 types of cancer: cancers of the lung, larynx, oral cavity and pharynx, esophagus, pancreas, bladder, stomach, colon and rectum, liver, cervix, kidney, and acute myeloid leukemia (AML).8

  • Within 5-10 years of quitting, your chance of getting cancer of the mouth, throat, or voice box drops by half.8
  • Within 10 years of quitting, your chance of getting cancer of the bladder, esophagus, or kidney decreases.8
  • Within 10-15 years after you quit smoking, your risk of lung cancer drops by half.8
  • Within 20 years after you quit smoking, your risk of getting cancer of the mouth, throat, voice box, or pancreas drops to close of that of someone who does not smoke. Also, the risk of cervical cancer drops by about half.8

Cancer Screening

Screening for Cervical and Colorectal Cancers

Research shows that screening for cervical and colorectal cancers, as recommended, helps prevent these diseases. Screening for cervical and colorectal cancers also helps find these diseases at an early stage when treatment is likely to work best. CDC offers free or low-cost cervical cancer screening nationwide.2 In addition, CDC’s Screen for Life: National Colorectal Cancer Action Campaign informs men and women aged 50 years and older about the importance of having regular colorectal cancer screening tests.9

Screening for Lung Cancer

People who have smoked for many years may consider screening for lung cancer.  The only recommended screening test for lung cancer is low-dose computed tomography (also called a low-dose CT scan, or LDCT). In this test, an X-ray machine scans the body using low doses of radiation to make detailed pictures of the lungs.

The U.S. Preventive Services Task Force recommendsexternal icon yearly lung cancer screening with LDCT for people who:10

  • Have a history of heavy smoking, and
  • Currently smoke or have quit within the past 15 years, and
  • Are between 55 and 80 years old.

Heavy smoking means a smoking history of 30 pack years or more. A pack year is smoking an average of one pack of cigarettes per day for one year. For example, a person could have a 30 pack-year history by smoking one pack a day for 30 years or two packs a day for 15 years.11

The task force recommends that yearly screening stop once a person turns 81 years old, has not smoked for 15 years, or develops a health problem that makes him or her unwilling or unable to have surgery if lung cancer is found.10

Talk to your doctor about lung cancer screening and the possible benefits and risks. Lung cancer screening is not a substitute for quitting smoking. If lung cancer screening is right for you, your doctor can refer you to a high-quality screening facility.11

How Is Cancer Treated?

The treatment for cancer depends on the type of cancer and the stage of the disease (how severe the cancer is and whether it has spread). Doctors may also consider the patient’s age and general health. Often, the goal of treatment is to cure the cancer. In other cases, the goal is to control the disease or to reduce symptoms for as long as possible. The treatment plan for a person may change over time.12

Most treatment plans include surgery, radiation therapy, or chemotherapy. Other plans involve biological therapy (a treatment that helps your immune system fight cancer).12

Some cancers respond best to a single type of treatment. Other cancers may respond best to a combination of treatments.12

For patients who get very high doses of chemotherapy or radiation therapy, a stem cell transplant, also known as a bone marrow transplant, may be recommended by their doctor. This is because high-dose therapies destroy both cancer cells and normal blood cells. A stem cell transplant can help the body to make healthy blood cells to replace the ones lost due to the cancer treatment. It’s a complicated procedure with many side effects and risks.12

Quitting smoking improves the outlook (the prognosis) for people with cancer. People who continue to smoke after diagnosis raise their risk for future cancers and death. They are more likely to die from cancer than nonsmokers and are more likely to develop a second (new) tobacco-related cancer.5

Colorectal Cancer and Ostomies

An ostomy (or stoma) is a surgical opening made to the body that allows waste to be eliminated from the body.13 Ostomies are used in treatment or management of cancer or other diseases.14 Ostomies are needed when the body’s normal opening is closed or altered as part of cancer treatment. An ostomy pouch is located around the opening to collect waste for removal. Ostomies are usually done during the first stages of surgical treatment to remove cancer.13 For patients with colorectal cancer, a colostomy (surgical openings from the bowel or colon to the abdomen) can be a lifesaving surgery.13,14 An ostomy can be temporary or permanent.13,14 Temporary ostomies are used while the affected area of the body heals. Permanent ostomies are used when cancer has resulted in the removal of the entire colon or the end of it.13,14

Additional Resources

The United Ostomy Associations of America (UOAA)external icon website focuses on the positive quality of life people can attain following ostomy surgery and provides information on a variety of topics, including:

  • Descriptions of ostomy terms
  • Frequently asked questions
  • Information about ostomy equipment
  • Tips for living with an ostomy
  • Support groups
  • Resources, including:
    • Ways to connect with others who have had ostomy surgery
    • Medical information
    • Information for specific individuals (e.g., children, women)
    • Information about food and nutrition

References

  1. National Cancer Institute. What Is Cancer? Defining Cancerexternal icon [last updated 2015 Feb 9; accessed 2020 January 27].
  2. Centers for Disease Control and Prevention. How to Prevent Cancer or Find It Early [last updated 2019 July 9; accessed 2020 January 27].
  3. American Cancer Society. Signs and Symptoms of Cancerexternal icon [last updated: 2014 August 11; accessed 2020 January 27].
  4. U.S. Department of Health and Human Services. A Report of the Surgeon General. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease.external icon Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010 [accessed 2020 January 27].
  5. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [2020 January 27].
  6. Centers for Disease Control and Prevention. Secondhand Smoke (SHS) Facts [last updated 2018 Jan 17; accessed 2020 January 27].
  7. World Health Organization International Agency for Research on Cancer. Smokeless Tobacco and Some Tobacco-Specific N-Nitrosaminesexternal icon [PDF – 3.19MB] [accessed 2020 January 27].
  8. U.S. Department of Health and Human Services. Smoking Cessation. A Report of the Surgeon General.pdf iconexternal icon Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020. [accessed 2020 February 19].
  9. Centers for Disease Control and Prevention. Screen for Life: National Colorectal Cancer Action Campaign [last updated 2019 July 1; accessed 2020 January 27].
  10. U.S. Preventive Services Task Force. Final Recommendation Statement: Lung Cancer: Screeningexternal icon. 2016 December. [accessed 2020 January 27].
  11. Centers for Disease Control and Prevention. Who Should be Screened for Lung Cancer? [last reviewed 2019 September 18; accessed 2020 January 27].
  12. American Cancer Society. Types of Cancer Treatmentexternal icon. [accessed 2020 February 19].
  13. American Cancer Society. Colostomy Guideexternal icon [accessed 2020 January 27].
  14.  National Institute of Diabetes and Digestive and Kidney Diseases. Ostomy Surgery of the Bowelexternal icon [last updated 2014 Aug 13; accessed 2020 January 27].