Prostate Cancer: Lean smokers are particularly at risk

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MunichSmoking is considered a risk factor for many types of cancer. Whether it also increases the likelihood of prostate cancer is not yet known.However, smokers are more likely to develop malignant forms of the tumor. Body weight also seems to play a role.

It was already noticed in the past that smokers in studies did not get measurably more likely to develop prostate cancer than non-smokers, but that they died more often as a result of the tumor disease. One possible explanation is that tobacco users are generally less health-conscious and that, on average, prostate cancer is discovered later in them.

Cancer cells grow faster

Researchers at the Duke University School of Medicine in the USA have now found another reason: their follow-up analysis of data from a large prostate cancer study showed that so-called low-differentiated tumors occur more frequently in smokers. These are forms of cancer that spread particularly quickly and respond less well to many common therapies.

Of the more than 6,400 Dr. Tammy Ho and her colleagues observed men over the age of 50 who were current (14.5 percent) or former smokers (39.8 percent). Around 46 percent had never smoked. All subjects were suspected of having an increased risk of prostate cancer due to the PSA levels in their blood. A tissue sample (biopsy) taken in the last six months before the start of the study had not yet detected any tumor cells.

Normal weight is a disadvantage

Two years later, the men underwent another prostate biopsy. Cancer cells were found in 17.2 percent of the men, and almost a third of the findings were low-differentiated, i.e. particularly malignant forms. The cancer cases were evenly distributed between smokers and non-smokers, but the malignant variants were more common among tobacco users.

Surprisingly, there was also a clear correlation with the constitution of the patients: the rate of low-differentiated prostate cancer was only increased in thin or normal-weight smokers (BMI below 25) - but then by up to 80 percent. Overweight smokers, on the other hand, had a similar distribution pattern for the various forms of cancer as fat non-smokers.

Early diagnosis improves the chances of recovery

However, it is questionable whether the greater risk of lean smokers for malignant prostate cancer also explains the higher mortality. Because Ho's team also found the general hypothesis of the less health-conscious smoker confirmed: Qualmer stopped the study particularly often.

Prostate cancer is the most common cancer in men. The chances of recovery are now good for most forms. However, due to the lack of clear symptoms, the disease is often discovered too late. The most important precaution is the rectal palpation examination by the family doctor or urologist. It is recommended once a year for men over 45 years of age. (jr)

Source: Tammy S. Ho et al .: Smoking and risk of low- and high-grade prostate cancer: Results from the REDUCE study, Clinical Cancer Research, October 2014

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