Substance use disorders among cancer patients. Which are the most frequent

Substance use disorders among cancer patients.  Which are the most frequent

It has been known for some time that substances such as smoking or alcohol are related to the development of tumors, but perhaps not everyone knows that the opposite is also true: those diagnosed with cancer can also develop a substance use disorder (Dus, a complex psychophysical condition that involves the uncontrolled use of a substance and which implies the loss of the ability to control its intake despite the risk of harm to oneself or others). And now a new search published on Jama Oncology and conducted in the USA shows that the correlation changes based on the type of cancer.

The 5 tumors for which Dus is most frequent

Katie F. Jones of the Veterans Affairs Boston Healthcare System and colleagues from other universities, authors of the work on Jama, used the data of over 6 thousand people diagnosed with cancer – a sample composed mainly of elderly people and women – who from 2015 to 2020 a questionnaire was administered annually in the context of the National Survey on Drug Use and Health. The analysis shows that among these cancer patients the percentage of those with a substance use disorder is 3.83%, and that the most widespread disorder is linked to alcohol (2.8%). The five cancers with the highest prevalence of Dus are: head and neck cancer, including those of the oral cavity, tongue, lips, throat and pharynx (9%), esophageal cancer (9%), gastric cancer (9%), cervical cancer (6%) and melanoma (6%).

Alcohol-related DUS is the most common among patients with head and neck cancer, cervical cancer and melanoma, while cannabis-related DUS is the most common in patients with esophageal and gastric cancers. According to the researchers, it is very important “to better understand the challenges that arise where cancer and DUS intersect, so that we can design interventions and programs to better support both patients who simultaneously manage cancer and addiction, and the doctors who care for them.” of them”.

The situation in Italy

Since we are talking about research carried out on a population with habits and lifestyles different from ours, we wonder whether the results obtained overseas can be “imported” into our country, if not in quantitative terms at least as a topic for reflection. “In Italy we do not have specific data on substance abuse among people diagnosed with cancer, however we have a couple of interesting works published in 2015 And in 2019 by Sebastiano Mercadante and Giampiero Porzio – he tells Oncoline Nicola Silvestrisnational secretary of the Italian Association of Medical Oncology (Aiom) and professor of oncology at the University of Messina – From these two publications it emerges that the phenomenon of alcohol abuse is not negligible among our cancer patients, especially among those undergoing treatment active, that is, among people while they are undergoing cancer treatment”.

Alcohol – explains the expert – is a toxic substance that can interfere with the metabolism of anticancer drugs in two ways: either by reducing their effectiveness or by increasing their toxicity. For this reason it is important to identify patients who use it and inform them about the risk associated with their habit. Something that isn’t always easy to do. “It may not be, it’s true – confirms the oncologist – because patients may have a tendency to underestimate their relationship with alcohol, or even hide it. But oncologists and doctors are asked to take care of these people, also understanding what is not said, and inform them about the possible impact of alcohol or other substances of abuse on treatment.”

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