Taking certain prostate cancer medications can increase the risk of heart-related deaths in men who have cardiovascular problems, according to a new study published in BJU International.
The study focused on androgen deprivation therapy (ADT), which fights to inhibit cancer cells by lowering levels of male hormones in the body. ADT is a widely used treatment for prostate cancer. Although it helps treat cancer, these drugs are linked to heart problems, including a higher risk of diabetes, coronary heart disease, heart attacks and sudden cardiac death.
The study was conducted by Paul Nguyen, MD, of the Dana-Farber/Brigham and Women’s Cancer Center in Boston, David Ziehr of Harvard Medical School and their colleagues. The researchers analyzed data from 5,077 men with prostate cancer who were treated between 1997 and 2006. ADT was used by thirty percent of these men.
After a median follow-up of 4.8 years, men were 3.3 times more likely to suffer heart-related deaths if they had congestive heart failure or prior heart attacks. Among this group, 7.01 percent of men receiving ACT suffered heart-related deaths compared to 2.01 percent of men who did not receive ACT after five years. These findings suggest that out of 20 men in this group, one would suffer cardiac death. In men without pre-existing cardiac conditions, there was no association with heart-related deaths.
“While androgen deprivation therapy can be a lifesaving drug for men with prostate cancer and significantly increase the cure rates when used with radiation for aggressive disease, this study also raises the possibility that a small subgroup of men who have significant heart disease could experience increased cardiac death on ADT,” Dr. Nguyen said, according to a press release. “I would still say that for men with significant heart problems, we should try to avoid ADT when it is not necessary—such as for men with low-risk disease or men receiving ADT only to shrink the prostate prior to radiation. However, for men with high-risk disease, in whom the prostate-cancer benefits of ADT likely outweigh any potential cardiac harms, ADT should be given even if they have heart problems, but the patient should be followed closely by a cardiologist to ensure that he is being carefully watched and optimized from a cardiac perspective.”