Hormone therapy for prostate cancer puts heart at risk

Administering androgen deprivation therapy (ADT) prior to surgery and combining ADT with radiation therapy are popular approaches to treating men diagnosed with advanced or high-risk localized prostate cancer. However, the potentially negative side effects of ADT are just now being explored. Researchers at Brigham and Women’s Hospital (BWH) have found that ADT may increase the risk of death from cardiovascular disease, particularly in men who undergo surgery for prostate cancer. These results are published in the Oct. 9 online issue of the Journal of the National Cancer Institute.

“Androgen deprivation therapy has been shown to be associated with an increased risk of developing type II diabetes and coronary artery disease,” said Henry K. Tsai, lead author of the study who conducted this research as a radiation oncology resident at the Dana-Farber/Brigham and Women’s Cancer Center. “This could be why we see an increased risk for cardiovascular death in men who receive this treatment.” 

ADT is used to reduce the level of male hormones in the body, and is thought to shrink prostate cancers or cause them to grow more slowly. ADT is frequently used to treat high-risk localized prostate cancer. Studies have shown that androgen deprivation therapy, when used with external beam radiation therapy, improves survival in patients with higher-risk prostate cancer.

Researchers followed 3,262 men who were treated for prostate cancer with either surgical prostate removal or with radiation therapy or cryotherapy. They found that men who had surgery and received ADT for an average of four months were at a higher risk for death from cardiovascular causes compared with men who did not receive ADT. Older age was also associated with a higher risk of death from cardiovascular disease.

“Clinical trials investigating the potentially negative effects of ADT on the cardiovascular system should be done to further explore this link. The results of this study and others support the need for careful cardiovascular evaluation and intervention before initiating ADT in patients with localized prostate cancer,” Tsai concluded. 

This study was funded through the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE) project by TAP Pharmaceutical Products Inc.