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Smokers Have Twice the Risk of Prostate Cancer Recurrence After Surgery as Never-Smokers

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Key Points

  • Around 30% of all prostate cancer patients treated with radical prostatectomy experience biochemical recurrence within 10 years after surgery.
  • Patients who had quit smoking within the last 10 years still had a significantly higher risk of cancer recurrence, at about the same level as that for current smokers.
  • Researchers found it took 10 years after a patient had quit smoking for the risk of cancer recurrence to drop significantly.

Current smokers, and those who have quit smoking less than 10 years previously, have twice the risk of a recurrence of prostate cancer after surgery, according to new research by Rieken et al presented at the European Association of Urology (EAU) 2015 Congress in Madrid (Abstract 508).

In 2012, prostate cancer accounted for over 92,000 deaths (9% of male deaths) in Europe. Around 30% of all prostate cancer patients treated with radical prostatectomy experience biochemical recurrence within 10 years after surgery.

Study Details

An international group of scientists and clinicians from the United States and Europe retrospectively looked at biochemical prostate cancer recurrence in 7,191 men who had had their prostate removed by radical prostatectomy. Of these men, roughly one-third were never-smokers (2,513, or 34.9%), one-third were former smokers (2,269, or 31.6%) and one-third were current smokers (3,409, or 33.5%). These patients were followed for an average of 28 months.

The results showed that after a median of 28 months, current smokers had around double (hazard ratio [HR] = 2.26) the chance of the cancer recurring than did patients who had never smoked. 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.

Experts’ Comments

According to lead researcher Malte Rieken, MD, of University Hospital in 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.”

Former EAU Secretary-General, Per-Anders Abrahamssonm, MD, PhD, of Lunds Universitet, said, “Prostate cancer is a leading cause of cancer death for men 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.”

Dr. Rieken is the corresponding author for the study.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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