Posted online on September 29, 2004 on www.jco.org [1]Read the original study [2]Head and neck cancer can occur in the mouth, tongue, tonsils, throat, vocal cords, or other areas of the head and neck. While smoking is considered a significant risk factor for developing the disease, not everyone with head and neck cancer is a smoker - 5% – 15% of all patients with the disease have never smoked.Although smoking is known to increase the risk of developing head and neck cancer, there is not much known about the impact of smoking on survival. Many important differences in age, sex, location of the tumor, stage of disease at the time of diagnosis, and type of treatment between smokers and nonsmokers with head and neck cancer make it difficult to determine if smoking is a factor in how long a patient lives.In a new study published in the Journal of Clinical Oncology, researchers at M. D. Anderson Cancer Center in Houston examined the impact of smoking on the survival of patients with head and neck cancer.Fifty smokers and 50 nonsmokers were matched by age, sex, stage of disease, location of the tumor, and the type of treatment they received. By matching these factors in each pair of patients, researchers were able to measure the effect of smoking on how long a patient lived. Factors such as alcohol use, other health problems, and cancer-related symptoms were also analyzed.The study showed that nonsmokers with head and neck cancer lived longer and were less likely to have their disease return than patients who were actively smoking or who had smoked in the past.In fact, the risk of death or having their disease return was more than three times higher for smokers than for nonsmokers.Researchers indicate that these findings suggest that smokers experience a different, and possibly more aggressive form of the disease than nonsmokers. They also noted that alcohol abuse, other health problems, or more severe side effects may contribute to the reduced length of life in smokers with the disease.What Does This Mean For Patients?The study underscores the importance of quitting smoking to reduce the risk of a variety of cancers, including head and neck cancer.In addition, the authors recommend that for today's head and neck cancer patients, quitting smoking and reducing alcohol intake, as well as aggressively managing disease symptoms and other health problems may help to improve survival and quality of life.The study may also help researchers better understand the different ways in which head and neck cancer can develop, and encourage the design of new and better treatments for different forms of the disease.