Can Smoking Increase My Prostate Cancer Risk?

Smoking has long been linked to a whole range of health problems and fatal diseases such as chronic obstructive pulmonary disease and cancers of the lung, liver and pancreas. While smoking has been found to increase the risk of mortality from prostate cancer, it is still unclear whether or not smoking increases your risk of getting prostate cancer.

There are several mechanisms that have been hypothesized to increase prostate cancer risk.

• Alterations in hormone levels

Tobacco smoking in men has been associated with increased testosterone levels and lower estradiol levels. This is important as testosterone and its more potent derivative, dihydrotestosterone (DHT), appear to increase cell proliferation in the prostate, which may be linked to malignancies in the prostate. Conversely, estrogens, like estradiol, are hormones that work to reduce androgen production, which can suppress tumor growth in the prostate.

Alterations to these hormone compositions in the body through smoking may create a more favorable environment for the growth of tumors in the prostate.

• Exposure to carcinogens

Smoking tobacco produces more than 70 carcinogens such as polycyclic aromatic hydrocarbons (PAHs) and cadmium. These may relate to prostate cancer. Changes in the genetic makeup or functional variations in genes responsible for metabolizing and eliminating PAHs may elevate the likelihood of developing prostate cancer. Glutathione-S-transferases (GSTs) belong to a group of enzymes capable of neutralizing PAHs. Some GST subtypes found in the human prostate have been documented as being linked to an increased risk of prostate cancer in individuals who smoke.

Different studies have had conflicting results with regards to smoking and prostate cancer risk. There are several possible reasons that have been identified to explain this disparity.

• Different research designs

Research studies that have been done to identify links between smoking and prostate cancer risk were designed and performed differently. This may have contributed to conflicting results.

• How well study was controlled (confounding factors)

There are many factors not relating to smoking that have an impact on prostate cancer risk. By accounting for these other risk factors and parameters, researchers can control the study to ensure as much unbiased data as possible. However, it is nearly impossible to account for and standardize all parameters on which the studies are based. As such, some studies may account for fewer factors than others, which may lead to varying results.

Common factors used to control such studies are factors like age and obesity.

Other factors such as exposure to second-hand smoke, dietary fat and cruciferous vegetable intake and adherence to prostate cancer screening are some of the more challenging factors that may influence a study.

• Smokers’ poor adherence to cancer screening

One common challenge in studies relating to smoking and prostate cancer risk is the adherence to prostate cancer screening. It was noted in multiple studies that smokers are generally less likely to go for prostate cancer screening. Since screening tends to increase the incidence of cancer, simply because it allows the detection of early-stage cancer, this leads to a possibly biased result that smoking is inversely associated with prostate cancer, which may not be accurate. On the other hand, less screening and early treatment could also contribute to a higher likelihood of dying from prostate cancer.

While current data may be inconclusive in determining if smoking affects prostate cancer prevention, it is known that people who smoke are more likely to die from prostate cancer and for prostate cancer to recur in patients who have already been treated. Together with the other health problems associated with smoking, it is always recommended to quit smoking altogether.

If you are concerned about prostate cancer or any other health issues related to smoking, it's crucial to seek advice from a healthcare professional. They can provide personalized information and support based on your specific situation. Remember that quitting smoking, even if you have been a long-time smoker, can immediately lead to significant health benefits.