How Dangerous is Smoking After Prostate Cancer?

It’s probably no surprise that smoking after prostate cancer is dangerous. If you have prostate cancer and also smoke, you are at increased risk of cancer recurrence as well as death from prostate cancer and cardiovascular disease compared with men with prostate cancer who never smoked. These findings appear in the June 22/29 issue of the Journal of the American Medical Association.

The study, which was conducted by Stacey A. Kenfield, ScD, of the Harvard School of Public Health, and colleagues, evaluated the relationship between cigarette smoking and stopping smoking with death from all causes, prostate cancer, and cardiovascular disease, as well as with recurrence of prostate cancer.  Data was gathered from 5,366 men who had been diagnosed with prostate cancer between 1986 and 2006 in the Health Professionals Follow-Up Study.

A total of 1,630 men died, including 524 (32%) from prostate cancer and 416 (26%) from cardiovascular disease. The remaining men died of various causes, including but not limited to other cancers (19.5%), neurological disease (6%), respiratory disease (5%), digestive tract disease (1%), kidney failure (1%), and other causes, including unknown. A total of 878 biochemical recurrences of prostate cancer were also noted.

When researchers compared men who had never smoked with current smokers, they found that the latter had an increased risk of dying from prostate cancer, cardiovascular disease, and all causes. Men who had quit smoking for 10 or more years had the same risk of dying of prostate cancer as did men who never smoked.

The investigators also found that men who smoked had an increased risk of biochemical recurrence of prostate cancer. This finding comes on the heels of another recent study (May 2011, Journal of the National Cancer Institute) from Johns Hopkins Bloomberg School of Public Health, in which researchers examined the association between smoking and recurrence of prostate cancer in 1,416 men who had undergone prostatectomy. The incidence of cancer recurrence was 34.3% among current smokers, 14.8% among former smokers, and 12.1% among men who never smoked.

The authors of the JAMA study explain that smoking may impact prostate cancer via the carcinogens in tobacco smoke, by raising levels of testosterone, and through nicotine-induced tumor growth and new blood vessel formation (angiogenesis).

The findings of the JAMA study show that “smoking at the time of diagnosis was associated with substantially increased overall mortality and prostate cancer mortality and recurrence.” The authors also concluded that their findings “provide further support that smoking may increase risk of death from prostate cancer.”

Read more in our Prostate Cancer Health Center.


Joshu CE et al. Cigarette smoking and prostate cancer recurrence after prostatectomy. J Natl Cancer Inst 2011 May 18; 103(10): 835-38

Kenfield SA et al. Smoking and prostate cancer survival and recurrence. JAMA 2011; 305(24): 2548-55