05 Mar Androgen Deprivation Therapy Increases Heart Risk
Common drugs to treat prostate cancer could treble the risk of heart death among those with a history of cardiac problems, a major study has found. One in three men diagnosed with prostate cancer are put on hormone therapy, to shrink tumours, slow their growth, and lower the risk of disease returning.
The new Harvard study tracked 5,000 men with the disease, with an average age of 70, one third of whom were put on androgen deprivation therapy. The research found that among those with a history of heart problems, risks of heart death rose sharply after undergoing the hormone treatment. Men who had previously had a heart attack, or suffered congestive heart failure, had three times the risk of heart-related deaths, compared to men who were not on the therapy, according to the study.
Overall, their risk of dying from a heart-related problem within five years was 7 per cent – compared with 2 per cent among those who were not on the therapy, the study found. By the age of 70, around one in ten men has suffered a heart attack or suffered from congestive heart failure.
Dr Paul Nyugen, from Harvard Medical School, said prostate cancer patients with a history of significant heart disease needed to carefully weigh up the pros and cons of hormone treatment.
“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,” he said.
He said men with a history of significant heart problems should try to avoid the therapy if it could be avoided, suggesting those who have been told their disease is “low-risk” might be better to avoid it.
Association of androgen deprivation therapy with excess cardiac-specific mortality in men with prostate cancer.
David R. Ziehr et al, BJU International; Published Online: October 29, 2014 (DOI: 10.1111/bju.12905).