One more reason to cut out the cigarettes


Surgeons already don’t like to operate on smokers. They don’t do as well during and after surgery as non-smokers, not least because smokers can have problems with anesthesia. Now come data suggesting that smoking during radiation therapy is a pretty lousy idea too.

Steinberger et al. have reported data from a retrospective review of 2,156 prostate cancer patients treated with radiation therapy at Memorial Sloan-Kettering Cancer Center in New York. They were able to categorize these patients into one of four groups: never smokers, current smokers, former smokers, and current smoking unknown. “Current smokers” were patients who were still smoking at the time of their initial consultation and the initiation of external beam radiation therapy (EBRT). “Former smokers” were patients who had smoked in the past but who stopped smoking before starting EBRT, even if they had stopped smoking weeks or even years before treatment.

Here are the key findings of the study:

  • Average (median) patient follow-up was 95 months (nearly 8 years).
  • Compared to the men who had never smoked at all
    • Current smokers had
      • A 40 percent increase in risk for PSA relapse post-treatment
      • A 2.4 times increase in risk of developing distant metastases
      • A 2.2 times increase in risk of prostate cancer-specific death
      • An 80 percent increase in risk for EBRT-related genitourinary toxicities
    • Former smokers had
      • A 45 percent increase in risk for EBRT-related genitourinary toxicities

The authors write that:

Current and former smokers, regardless of duration and quantity of exposure, are at an increased risk of long-term genitourinary toxicity after EBRT.

Oncologists should encourage patients prior to therapy to participate in smoking-cessation programs to potentially lower their risk of relapsing disease and post-treatment toxicities.

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