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Prostate cancer medications linked to increased heart-related death risk.

A new study has found that certain prostate cancer medications are linked with an increased risk of dying from heart-related causes in men with congestive heart failure or prior heart attacks. The findings will help doctors and patients weigh the benefits and risks of the drugs.

Androgen deprivation therapy (ADT), which reduces levels of male hormones in the body to prevent them from stimulating cancer cells, is a mainstay of treatment for prostate cancer. Despite its anticancer effects, ADT has been associated with heart problems, including increased risk of diabetes, coronary heart disease, heart attacks, and sudden cardiac death.

To investigate this potential link thoroughly the Dana-Farber Cancer Institute, Brigham Women’s Cancer Center and the Harvard Medical School analyzed information on 5,077 men with prostate cancer who were treated between 1997 and 2006. Thirty percent of these men received ADT, while the others did not.

After a median follow-up of 4.8 years, no association was detected between ADT and heart-related deaths in men with no cardiac risk factors (1.08 percent at five years for ADT versus 1.27 percent at five years for no ADT) or in men with diabetes, hypertension, or high cholesterol (2.09 percent vs 1.97 percent).

However, ADT was associated with a 3.3-times increased risk of heart-related deaths, in men with congestive heart failure or prior heart attacks. In this subgroup, heart-related deaths occurred in 7.01 percent of men receiving ADT versus 2.01 percent of men not receiving after five years. This suggests that administering the therapy to 20 men in this potentially vulnerable subgroup could result in one cardiac death.

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.

The team noted that because the study was retrospective, it must be carefully weighed against larger controlled trials that have demonstrated the benefits of ADT.  This aside, the researchers still state that for men with significant heart problems the medical community 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 they are being carefully watched and optimized from a cardiac perspective.

Source:  John Wiley & Sons, Inc.

A scanning electron micrograph of a prostatic cancer cell magnified 6000x.  Credit: Reuters/Newscom.
A scanning electron micrograph of a prostatic cancer cell magnified 6000x. Credit: Reuters/Newscom.

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Michelle Petersen is the founder of Healthinnovations, having worked in the health and science industry for over 21 years, which includes tenure within the NHS and Oxford University. Healthinnovations is a publication that has reported on, influenced, and researched current and future innovations in health for the past decade.

Michelle has been picked up as an expert writer for Informa publisher’s Clinical Trials community, as well as being listed as a blog source by the world’s leading medical journals, including the acclaimed Nature-Springer journal series.

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Most recently the Texas A&M University covered The Top 10 Healthinnovations series on their site with distinguished Professor Stephen Maren calling the inclusion of himself and his team on the list a reflection of “the hard work and dedication of my students and trainees”.

Michelle Petersen’s copy was used in the highly successful marketing campaign for the mega-hit film ‘Jumanji: The Next Level, starring Jack Black, Karen Gilian, Kevin Hart and Dwayne ‘The Rock’ Johnson. Michelle Petersen’s copywriting was part of the film’s coverage by the Republic TV network. Republic TV is the most-watched English language TV channel in India since its inception in 2017.

An avid campaigner in the fight against child sex abuse and trafficking, Michelle is a passionate humanist striving for a better quality of life for all humans by helping to provide traction for new technologies and techniques within healthcare.

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