Common Prostate Therapy Treatment May Increase Risk of Death from Heart Disease: Study

Side effects of hormone therapy used to treat prostate cancer may increase the risk of death from cardiovascular disease among older men, according to the findings of a new study.

Androgen deprivation therapy (ADT) is a hormone therapy commonly used among prostate cancer patients, but new research indicates it may increase the risk of death from heart disease. The findings were published June 14, in the journal The Aging Male.

Researchers from Lithuania conducted a retrospective study of patients ages 40-79 years old and diagnosed with prostate cancer between 2012 and 2016 using used data from the Lithuanian Cancer registry. This included 13,343 prostate cancer patients. They compared roughly 3,800 men who exclusively used gonadotropin-releasing hormone agonists and 9,500 patients who did not.

The findings suggest patients who used ADT had an increased risk of cardiovascular death compared to non-users. Men who took ADT had double the risk of dying from cardiovascular disease compared to men who didn’t undergo therapy. They also had a higher risk of heart disease-related death beginning the second year after diagnosis.

Men between the ages of 70 and 79 had a five-fold increased risk of death from cardiovascular disease.

Overall, the risk of dying from a stroke increased 42% and the risk of dying from coronary heart disease increased by 70% when men took ADT.

“This study shows that ADT usage is associated with increased cardiovascular disease-related mortality risk for patients diagnosed with prostate cancer compared with ADT non-users,” the researchers determined. “The highest mortality risk was found for ischemic heart disease and stroke.”

Hormone therapy, or ADT, is commonly used in prostate cancer patients who have high-risk localized cancer or advanced cancer that has metastasized.

According to the researchers, ADT should be started only with careful thought if the patient is over 70 years old and has heart disease. Patients should discuss using ADT with their doctors and for how long it is appropriate. It should be considered on a case-by-case basis. Doctors should also screen older patients for heart disease and other risk factors.

The study was only an observational study, so it cannot prove cause and effect between the two.

Doctors also suggest patients who have cancer that has not metastasized could undergo surgery and not receive hormone therapy. Patients who undergo radiation may be able to undergo the treatment without hormonal therapy as well, or may need only a short course of therapy. Other therapies may also pose a risk of cardiovascular disease, such as immunotherapies and cytotoxic chemotherapies.

The researchers called for doctors to receive improved tools to better determine who would benefit most from hormonal therapy and said some patients may need to be monitored more closely for blood pressure and cholesterol.