WEDNESDAY, Sept. 23, 2020 — Patients who have surgery for bladder cancer fare worse if they smoke, new research shows.

“This study is important because while it is known that tobacco smoking is the leading cause of bladder cancer, this is the first study to suggest that smoking puts bladder cancer patients at risk after diagnosis,” said study co-author Dr. Giovanni Cacciamani. He’s an assistant professor of research urology at the University of Southern California Keck School of Medicine.

When bladder cancer has spread beyond the bladder, patients are usually given chemotherapy and a surgical procedure called a radical cystectomy. This involves removal of the bladder, nearby lymph nodes and surrounding organs.

For the new study, Cacciamani’s team reviewed 17 previously published studies that looked at the effect of smoking on chemotherapy response and survival outcomes of nearly 14,000 patients after a radical cystectomy.

The investigators found that people who smoked had a worse response to chemotherapy and had higher death rates in general, and also from bladder cancer. These patients also had higher odds of bladder cancer recurrence, compared with patients who never smoked or were not smokers at the time of surgery.

Former smokers also had worse outcomes than those who never smoked, although the differences were not as significant, the findings showed.

Nicotine suppresses the immune system, causing more complications, the researchers noted.

“In addition, patients with a history of smoking tend to have more aggressive forms of cancer and, if they survive bladder cancer, are more at risk for other potentially fatal cancers, such as lung cancer,” Cacciamani said in a university news release.

“The research suggests that as long as a person is not smoking at the time of chemotherapy and surgery, they might do better,” he added.

The report was published online in the October issue of the Journal of Urology.

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