Prostate Cancer Hormone Therapy Safe

Prostate cancer androgen deprivation therapy not linked to fatal heart attacks

(RxWiki News) Prostate cancer treatment often involves hormone-blocking therapy. Some studies have suggested this treatment has dangerous side effects. New research, though, says men need not worry.

Androgen deprivation therapy (ADT) is not linked to higher risks of fatal heart attacks, a finding that contradicts several studies which have been cited by the U.S. Food and Drug Administration (FDA) and some professional organizations.

"Talk to you doctor about the side effects of all therapies."

The Dana-Farber/Brigham and Women's Cancer Center report says fears of ADT causing cardiovascular events are unwarranted - at least for men who don't have a history of heart disease.

Paul Nguyen, M.D and Toni Choueiri, M.D. analyzed studies involving 4,141 prostate cancer patients. Their analysis found the rates of cardiovascular deaths were no different among men who were receiving ADT and those who were not getting the therapy.

At the same time, investigators said this study did not demonstrate that ADT could increase risks among men with a history of heart disease.

ADT is often used along with radiation therapy to treat difficult tumors and cancers that have spread beyond the prostate.

The side effects of ADT include weight gain, insulin resistance and problems with blood lipids including cholesterol. All of these issues increase cardiovascular disease risks.

In 2006, concern surfaced when researchers reported an association between ADT and a 44 percent increased risk of diabetes, 11 percent increase in heart attacks, and a 16 percent increase in sudden cardiac death. Another study found men older than 65 who were treated with ADT suffered heart attacks sooner than those who weren't on the drugs.

Several organizations including the American Heart Association, the American Cancer Society and the American Urological Association issued a joint statement in 2010 alerting physicians to the potential cardiovascular risk. The FDA called for labeling on hormone-blocking drugs in 2010, warning of an increased risk of diabetes, heart attack, sudden cardiac death, and stroke.

dailyRx spoke with Brian J. Miles, M.D., a urologist at Methodist Hospital in Houston. "Although this study is reassuring it still remains imperative for urologists to assess their patients overall risks in light of the need for ADT," Dr. Miles said.

"Furthermore, this study does not address the fact that a number of studies have also shown an increased risk of diabetes mellitus and obesity on chronic ADT. These facts must also be taken into account when considering long-term ADT. Nonetheless, for someone with advanced/metastatic adenocarcinoma of the prostate the standard of care would require the patient to immediately go on ADT," Dr. Miles said.

Investigators say they plan to look study cardiovascular risks in men taking ADT who have a history of heart disease.

This meta-analysis is published in the December 7, 2011 edition of JAMA (Journal of the American Medical Association).

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Review Date: 
December 6, 2011