Men with localized prostate cancer who received androgen deprivation therapy may be at greater risk of heart failure than those who did not receive the treatment, a new study suggests.
Androgen deprivation therapy (ADT) is a type of therapy that reduces the levels of male hormones – androgens – to prevent them from promoting the growth of prostate cancer cells. It has been used widely for patients with advanced prostate cancer. More recently, it is being used increasingly to treat patients in the early stages of the disease, before it has spread.
While some studies with elder patients suggest that ADT may increase the risk for cardiovascular disease, there is still conflicting evidence regarding the association between ADT and cardiovascular problems.
Using records from Kaiser Permanente Southern California (KPSC) healthcare delivery system, authors underwent a prospective study with men newly diagnosed with localized prostate cancer, who initially were under active surveillance. This is a monitoring strategy to ensure the cancer hasn’t spread outside the prostate.
Studying records from 7,637 subjects, they looked at how ADT affected patients’ risk for cardiovascular disease. Nearly 30 percent were exposed to ADT and patients were followed for up to 12 years after diagnosis.
The analysis showed that ADT increased the risk for heart failure in patients without a pre-existing cardiovascular disease by 81 percent. Those who already had a cardiac condition also had increased risk for additional problems, including dysfunctions to the heart rhythm, and a 44 percent higher risk for developing arrhythmia. These patients also were three times more likely to develop interruptions of the electrical impulses to the heart, a condition known as conduction disorder.
“The implication is that patients with localized prostate cancer should be followed to minimize the health effects of androgen deprivation therapy on the cardiovascular system,” said Reina Haque, PhD, MPH, in a press release. Haque is a researcher with the Kaiser Permanente Southern California Department of Research & Evaluation, and lead author of the study. “Patients should consider lifestyle changes, and physicians should actively monitor the patient’s health for early signs of heart disease,” she said.
“The findings allow men with localized prostate cancer to consider the positive and negative effects of androgen deprivation therapy and discuss it with their physicians. If they move forward with the therapy, patients should work with their physicians to adjust their lifestyle to reduce the risk of cardiovascular disease,” Haque concluded.