Prostate cancer and smoking: Why the two may be deadly

Kathleen Blanchard's picture
Prostate cancer and smoking
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Research points to higher risk of prostate cancer among men who are smokers, but few studies have looked at prostate cancer recurrence and mortality in association with tobacco carcinogens. Now scientist say men who smoke at the time of prostate cancer diagnosis face a higher chance that the disease will become more aggressive. The combination of smoking and cancer diagnosis was also linked to an increased chance of dying from heart disease and all causes.

How tobacco carcinogens might promote prostate cancer

The link between smoking and dying from prostate cancer isn’t entirely understood, but researchers say biologically, tobacco carcinogens promote tumors and higher testosterone levels that could be fueling the disease.

Other mechanisms of why prostate cancer is more deadly for men who smoke might be from the way chemicals in tobacco alter DNA, leading to methylation, shown in some studies.

Nicotine can promote new blood vessel growth in tumors that in turn allows cancer to grow and spread.

In the study, Stacey A. Kenfield, Sc.D., of the Harvard School of Public Health, Boston, and colleagues found smoking and prostate cancer also leads to higher risk of dying from cardiovascular disease in an analysis of 5,366 men diagnosed with prostate cancer between 1986 and 2006 in the Health Professionals Follow-Up Study.

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There were 524 deaths from prostate cancer and 416 from cardiovascular disease (CVD). Among the participants, 878 had recurrence of the disease.

When the researchers compared men who currently smoke to former smokers, they found the link between tobacco use and higher chance that cancer of the prostate would return and overall increased risk of dying.

The authors of the study, published in the Journal of the American Medical Association, write, “Ten-year quitters had risks similar to never smokers. These results provide further support that smoking may increase risk of death from prostate cancer.”

The number of years of smoking was also linked to increased chance of dying from CVD and overall mortality for men with prostate cancer, but not to recurrence of the disease.

JAMA. 2011;305[24]2548-2555
doi: 10.1001/jama.2011.879
"Smoking and Prostate Cancer Survival and Recurrence"
Stacey A. Kenfield, ScD; Meir J. Stampfer, MD, DrPH; June M. Chan, ScD,
Edward Giovannucci, MD, ScD

Image credit: Morguefile

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