Smoking linked to poor cancer prognosis

This study analyzed the association between cigarette smoking and prostate cancer outcomes.

Cigarette smoking is the number one cause of preventable morbidity and mortality. Although smoking has long been known to increase the risk of several cancers, including lung and kidney, its effect on prostate cancer prognosis remains unclear. Furthermore, the effect of smoking on the effectively of different cancer treatments is still under debate.

The medical records of 1450 men diagnosed with prostate cancer, and who underwent a radical prostatectomy (surgical removal of the prostate gland), were reviewed in this analysis. According to preoperative notes, 549 men (33%) men were active smokers and 1121 (67%) were non-smokers at the time of surgery.

Over an average follow-up of more than 5 years, 509 men experienced a rise in PSA levels (prostate specific antigen; a protein produced by prostate cells) indicating the possibility of cancer recurrence (referred to as biochemical recurrence). Smoking was found to be associated with a 25% increase in the risk of biochemical recurrence.

Among patients being treated with hormonal therapy, the risk of the cancer becoming resistant to treatment (referred to as castration resistant prostate cancer) was found to be 2.6 times higher among smoking men.

Overall, 26 men experienced cancer metastasis. The risk of prostate cancer metastasis was found to be 2.5 times higher among smokers compared to non-smokers. Smoking was also found to double the risk of mortality among prostate cancer patients.

This study concluded that cigarette smoking is significantly associated with an increased risk of cancer recurrence after surgery, treatment resistance, cancer metastasis and mortality.

Although this study only included men with advanced prostate cancer, treated by radical prostatectomy, it may be assumed that results hold relevance for men with early stage cancer as well.