Smokers at twice risk of prostate cancer recurring after surgery

Prostate cancer is the third most common male cancer in Europe, accounting for over 92,000 deaths in 2012 (9% of male deaths). Around 30% of all prostate cancer patients treated with radical prostatectomy experience biochemical recurrence (defined by an increase in PSA, prostate specific antigen) within 10 years after surgery

An international group of scientists and clinicians from the USA and Europe retrospectively looked at biochemical prostate cancer recurrence -- in 7191 men who had had their prostate removed by radical prostatectomy. Of these men, roughly a third were never smokers (2513, or 34.9%), a third were former smokers (2269, or 31.6%) and a third were current smokers (3409, or 33.5%). These patients were followed up for an average of 28 months.

The results showed that after a median of 28 months, current smokers had around double (HR 2.26) the chance of the cancer recurring than did patients who had never smoked (see abstract below for full results). Even those who had quit smoking within the last 10 years still had a significantly higher risk of cancer recurrence, at about the same level (HR 2.03) as that for current smokers. It wasn't until 10 years after a patient had quit smoking that the risk of cancer recurrence dropped significantly.

According to lead researcher Dr Malte Rieken (University Hospital, Basel, Switzerland): "This is a new analysis, but it seems to confirm results we have seen in many other types of cancer: basically, smoking increases the risk of cancer recurrence after initial treatment. Prostate cancer mortality varies widely throughout Europe. The fact that cancer recurrence can vary so dramatically due to smoking is probably one of the factors which may contribute to differences in prostate cancer mortality. It's just another reason not to smoke at all, but the fact that the risk drops after 10 years means that anyone who has prostate cancer, would be well advised to quit immediately."

Commenting former EAU Secretary-General, Per-Anders Abrahamsson (Malmo, Sweden) said: "Prostate cancer is a leading cause of cancer death for man in the western world. A number of studies have addressed how diet and environmental factors affect the risk of prostate cancer. This is the first report that clarifies that smoking increases the risk of prostate cancer recurring after surgery and, therefore, a major step forward to advise our patients to stop smoking when diagnosed with prostate cancer."