Risk worth monitoring: Treatment for early-stage prostate cancer

Clinical Brief – September 5th

The Brief

In a study, researchers found that routine hormonal treatment for early prostate cancer may be linked to an increased risk of heart disease.

The cause of this is not clear. Researchers suggest closer monitoring for at-risk men who are receiving treatment.

Early treatment for prostate cancer?

Androgen deprivation therapy (also known as ADT), is a hormonal treatment recommended for advanced prostate cancer. According to the researchers who ran the study, it is also increasingly being used for early stage prostate cancer.

ADT lowers testosterone to castration levels within 3 weeks. Studies have been back and forth about the benefits and risks of ADT and in particular, the potential risk of heart disease.

What did the study find?

For this study, researchers looked at over 7,600 patients from California, US, who were diagnosed with early prostate cancer between 1998-2008 who initially underwent active surveillance. By 2010, 30% of patients had been treated with ADT and ten patients developed cardiovascular problems.

From this data set, researchers concluded that

  • For men with no pre-existing heart disease, ADT was linked to an 81% increased risk of heart failure vs those who didn’t receive treatment.
  • For men with pre-existing heart disease, ADT was linked to a 44% increased risk of arrhythmia and a 3-fold increased risk of conduction disorder of the heart.

Bottom line

Overall, the rate of heart disease is rare. In this sample, only 1 in 250 people who were treated with ADT experienced a heart-related adverse event.

But these results are real, and I really liked how the authors interpreted their results.

“This study provides the basis for identifying high-risk men treated with ADT who might benefit from regular cardiac monitoring and lifestyle modification recommendations.”

– Haque R, et al.

In other words, know that the risk is there and plan for it accordingly. Now, if only all risk-factor studies were interpreted like this…

One thought on “Risk worth monitoring: Treatment for early-stage prostate cancer

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