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Exploring the Wide-Reaching Impact of Smoking on Cancer
During the conversation, Dr. Bjurlin highlighted how smoking remains one of the leading risk factors for various cancers, including bladder cancer. He explained the biological pathway through which carcinogens from inhaled smoke travel through the body, leading to increased risk not only for lung and throat cancers but also for kidney and bladder cancers. With approximately 50% of bladder cancer patients having a history of smoking, the episode emphasizes the critical need for education, early detection, and preventive strategies.
Dr. Bjurlin also provided context on how the smoking landscape has evolved. While traditional smoking rates have decreased in recent years, e-cigarette use among younger populations has risen. He noted that while e-cigarettes may involve fewer harmful combustion byproducts, evidence has shown that carcinogenic chemicals present in e-cigarette users’ urine could still pose serious risks, including the development of bladder cancer.
A Call to Action for Early Detection and Cessation Support
Throughout the episode, Dr. Bjurlin underscored the importance of early recognition of symptoms, particularly for smokers, and provided practical advice for those at risk. He urged individuals with a smoking history to be aware of signs such as blood in the urine and to seek prompt medical evaluation if they experience this symptom. Furthermore, he stressed that while current guidelines do not advocate for routine bladder cancer screenings for smokers, lung cancer screening may be beneficial for certain patients based on smoking history.
The episode also explored the role that health professionals and institutions can play in advancing smoking cessation initiatives. Dr. Bjurlin shared results from a quality improvement project at UNC, where the introduction of tobacco cessation support during post-operative hospital stays for radical cystectomy patients led to a significant reduction in smoking rates and improved engagement with cessation programs.
Breaking Down Barriers to Quitting
For those seeking to quit smoking, Dr. Bjurlin emphasized the importance of combining pharmacotherapy and behavioral strategies. He discussed various cessation tools, including nicotine replacement therapy, prescription medications, and support programs, as well as innovative approaches such as telehealth and mobile follow-ups to make cessation support more accessible.
Dr. Bjurlin’s message was clear:
“Quitting is a journey—it’s not going to happen overnight. It’s often filled with ups and downs, but with support and persistence, success is achievable. Celebrate small victories and be kind to yourself along the way.”
Advocacy for Change in Cancer Care Guidelines
As a panel co-chair at the 2024 BCAN Bladder Cancer Think Tank focused on smoking cessation, Dr. Bjurlin also emphasized the need for stronger integration of tobacco use screening and cessation recommendations into clinical guidelines for bladder cancer care. His research revealed that while smoking is a leading risk factor for both lung and bladder cancers, clinical guidelines for bladder cancer are significantly less likely to address tobacco use and cessation than those for lung cancer. This discrepancy underscores the need for continued advocacy and education among medical professionals to ensure equitable and evidence-based care for patients with smoking-related malignancies.