Smoking has also been found to be a risk factor for prostate cancer progression and mortality in cohort studies24 and systematic reviews.8 Low albumin was associated with prostate cancer mortality in the Apolipoprotein-related MOrtality RISk (AMORIS) cohort25 and, along with anaemia,26 was a more widely accepted predictor of poor cancer outcomes.27 The published literature around the prognostic effect of beta-blockers for prostate cancer patients has been more mixed,28 with this study lending weight to the evidence of increased mortality in patients with cancer. This evidence concerns the gene ALB and anemia.