A look at the link between smoking and aggressive prostate cancer in men 

In the perpetual battle against the hazards of smoking, if men want another reason to quit, how about this: Besides increasing the risk of heart disease and cancers of the lung, kidney, and bladder, lighting up will also elevate the odds of a diagnosis of aggressive prostate cancer. Aggressive prostate cancer means cancer that has spread or metastasized to the bones or lymph nodes, increasing the fatality rate.

This revelation that has challenged the preconceived notion that only the lungs bear the brunt of this harmful habit. Pioneering research has uncovered a profound connection between smoking and an increased likelihood of succumbing to prostate cancer.

Smoking induces DNA mutations and inflammation

But the question remains: how does smoking, a habit primarily linked to lung-related issues like lung cancer, become a sinister accomplice in the progression of prostate cancer? The reason is that smoking’s pervasive influence extends to every cell in the body. When smoking a lighted cigarette, they are a complete carcinogen. Smoking induces DNA mutations and inflammation, replacing healthy lung cells with scar tissue akin to soot buildup in a chimney.

While we still do not fully understand the exact mechanisms of smoking’s impact on prostate cancer, ongoing scientific advancements have unraveled more information on this puzzle. There was a time when the medical belief was that men who smoked did not raise their risk of developing prostate cancer. This notion, however, has been debunked, and today, we have a better understanding of the complex relationship between men who smoke and prostate cancer.

Just recently, a 2023 study found that smokers have a 42% higher risk of dying from prostate cancer compared to non-smokers. But here is the catch: did those who died from other things also have hidden prostate cancers? Some experts think that because smoking can lead to different kinds of deaths, some smokers might not live long enough to die from prostate cancer.

To clear this up, researchers focused on over 22,000 men who recently had surgery for prostate cancer but were otherwise healthy. After about six years, they found that guys with prostate cancer who smoked were almost twice as likely to die from it (an 89% higher risk) compared to non-smokers. Smokers also had a 151% higher chance of the cancer spreading and a 40% higher chance of the cancer coming back after surgery.

There is also a critical distinction between lethal and non-lethal prostate cancer, shedding light on the nuanced impact of smoking. Interestingly, smoking does not appear to elevate the risk of low-grade prostate cancer, the more treatable variety that may not require intervention. However, it significantly heightens the risk of cancer progression post-diagnosis and raises the risk of succumbing to the more aggressive and lethal forms of prostate cancer. In other words, men refrain from smoking at all costs. 

The connection between smoking and prostate cancer is not entirely crystal clear. It might be the harmful stuff in cigarette smoke getting into the prostate through urine, causing inflammation. Or it could be that smoking usually comes with other not-so-healthy habits like not exercising enough or drinking too much.

Emphasizing the association between smoking and prostate cancer mortality merits attention. The critical takeaway is clear: the consequences of smoking extend beyond the obvious respiratory conditions, creating an insidious link to prostate cancer that demands consideration and action.

The message is simple – if you are dealing with prostate cancer and you smoke, the best thing you can do is quit. 


Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncolo gy and prostate cancer 911. 




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