Sperling Prostate Center

How Cigarettes Cut Chances of Surviving Prostate Cancer

There’s a saying that where there’s breath, there’s hope. Sadly, that’s less true for smokers. With each drag on a cigarette, a tiny glimmer of hope is diminished with that breath. That’s bad news.

Thankfully, there’s some good news. More U.S. smokers are rejecting the smoking habit. The big picture statistics are a sign of hope. The overall percentage is shrinking. USA Facts tells us that the rate has dropped from 23.4% in 1996 to 15.5% in 2020. Progress in raising awareness of tobacco’s harms appears to be working.

Still, when we do the math, the raw numbers are astonishing. The U.S. Census Bureau estimates today’s population at 334, 233, 854 as of January 1, 2023. More men than women are smokers (16.7% of adult males vs. 13.6% of adult females). This means that over 58,800,000 men are smokers! One out of eight
will be diagnosed with prostate cancer (PCa) in his lifetime, which comes out to roughly 7 million smokers who will get or already have PCa.

It’s a sad fact: these men have poorer odds of surviving than their nonsmoking counterparts. This is true regardless of other factors like family history, ethnicity, environmental exposure, etc., as well as type of treatment received. Smoking seems to be an equal opportunity killer.

A 2018 review of published literature on tobacco use among men diagnosed with PCa examined the link between smoking and overall survival (death from any cause), PCa-specific survival (death from prostate cancer), and recurrence. The authors found “a significantly increased risk of overall mortality, prostate cancer specific mortality and recurrence.”[i]

How does smoking lead to PCa risk? The exact causal factors are still being studied. An earlier study based on data from the Seattle-Puget Sound Cancer Registry notes, “Cigarette smoking may increase the risk of prostate cancer by affecting circulating hormone levels or through exposure to carcinogens.”[ii] The Harvard Health Blog rounds out the theory:

The cancerous pollutants that smokers inhale are excreted to some extent in urine, which flows through the prostate. Smoking might boost levels of toxic inflammation. Or perhaps it’s not even the smoking itself, but the poor lifestyle choices that often accompany it, such as inadequate exercise, or excessive alcohol use.

It’s a complex problem with sobering numbers. PCa patients who smoke are 89% more likely to die from their disease, have a 151% higher likelihood of cancer spread, and a 40% greater chance of post treatment recurrence. But remember: where there’s clean breath, there’s hope. The day a smoker stops, these statistics begin to go down. The more years between quitting smoking and being diagnosed with PCa, the better the survival statistics.[iii] Even quitting on the day of diagnosis improves survival.

If you’re a smoker, there’s no way to know if you’re the one man out of eight who will develop PCa. Don’t take chances. Quit smoking today! If you need help, turn to the American Cancer Society for starters. There are many programs with solutions tailored to individual needs, and some of them have no cost. For more information, call the ACS at 1-800-227-2345.

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

[i] Darcey E, Boyle T. Tobacco smoking and survival after a prostate cancer diagnosis: A systematic review and meta-analysis. Cancer Treat Rev. 2018 Nov;70:30-40.
[ii] Plaskon LA, Penson DF, Vaughan TL, Stanford JL. Cigarette smoking and risk of prostate cancer in middle-aged men. Cancer Epidemiol Biomarkers Prev. 2003 Jul;12(7):604-9.
[iii] Kenfield SA, Stampfer MJ, Chan JM, Giovannucci E. Smoking and Prostate Cancer Survival and Recurrence. JAMA. 2011;305(24):2548–2555.


About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.

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