Hormone Therapy in Prostate Cancer Increases Risk of Heart Disease

Posted on October 6th, 2009 by

Hormone therapy used to treat men with advanced prostate cancer may lead to an increased risk of heart disease, according to the results of a study presented on September 22, 2009 at Europe’s largest cancer congress, ECCO 15-ESMO 34, in Berlin.[1]

Prostate cancer is the second most common cancer among men worldwide, after lung cancer. Standard therapy for early prostate cancer may include surgery, radiation therapy, hormone therapy (androgen-deprivation therapy), or watchful waiting (no treatment until disease progression). Optimal treatment for early prostate cancer is still under debate and may depend on several factors, including the underlying health of the patient.

Hormone therapy, or androgen deprivation therapy (ADT), can slow prostate cancer growth by reducing levels of testosterone. Some types of ADT work by blocking testosterone from binding to prostate cells, whereas others work by reducing the production of testosterone. Now, research indicates that certain types of ADT are associated with an increased risk of heart disease.

A large study in Sweden involved 30,642 men with locally advanced or metastatic prostate cancer who received ADT as primary treatment between 1997 and 2006. Most patients received one of three hormone therapies: removal of the testicles (orchiectomy), injections of gonadotropin-releasing hormone agonists to reduce testosterone production, or anti-androgen pills to block testosterone from binding to prostate cells. Some men (38%) received a combination of the two types of drugs.

After an average of three years of follow-up, the researchers found that prostate cancer patients treated with hormone therapy had an increased risk of developing various heart problems. This risk was highest among patients receiving the gonadotropin-releasing agents and lowest among those taking the anti-androgen therapy. Men who already had heart disease at baseline saw a less pronounced increase in their risk. Men who underwent orchiectomy experienced similar increase in heart disease as those receiving the gonadotropin-releasing drugs.

Overall, the use of hormone therapy in prostate cancer patients resulted in:

  • 24% increased risk of a non-fatal heart attack; 28% increased risk of a fatal heart attack
  • 19% increased risk of arrhythmia; 5% increased risk of fatal arrhythmia
  • 31% increased risk of ischemic heart disease; 21% increased risk of dying from heart disease
  • 26% increased risk of heart failure; 26% increased risk of dying from heart failure

The researchers concluded that hormone therapy in prostate cancer patients increases the risk of heart disease, but the extent of the increase may vary by type of hormone therapy.

Reference:

[1] Van Hemelrijck M, Garmo H, Bratt O, et al. Increased cardiovascular morbidity and mortality following endocrine treatment for prostate cancer: An analysis in 30,642 men in PCBaSe Sweden. European Journal of Cancer Supplements, Vol. 7, No. 3, September 2009. Abstract 1BA.

Copyright © 2010 CancerConsultants Prostate Cancer Information Center. All Rights Reserved.

Tags: Uncategorized

You must be logged-in to the site to post a comment.