Heart Risk From Prostate Therapy
Androgen Deprivation for Prostate Cancer Boosts Heart Deaths
Androgen Deprivation Risk, Androgen Deprivation Benefit continued...
The study showed no significant risk for men who received androgen deprivation therapy along with other prostate cancer treatments. However, Tsai considers this to be a statistical fluke due to the relatively small number of study patients given treatments other than surgery.
That's also the opinion of Jerome Seidenfeld, PhD, associate director of the Blue Cross and Blue Shield Association's technology evaluation center in Chicago. Seidenfeld's editorial accompanies Tsai and colleagues' report in the Oct. 17 issue of the Journal of the National Cancer Institute.
Seidenfeld warns that while the data from Tsai and colleagues sounds an alarm, there's still too little data to understand the true heart risk from androgen deprivation therapy.
"There is evidence in this paper that those using androgen deprivation therapies are different in a number of ways from patients not using it -- so we don't know if their underlying cardiovascular risk is the same," Seidenfeld tells WebMD.
But Seidenfeld and Tsai agree that doctors should evaluate a patient's risk of heart disease before recommending androgen deprivation therapy -- and that patients considering these treatments should be made aware of this possible risk.
Shehzad Basaria, assistant professor of endocrinology and metabolism at Johns Hopkins University, says his own studies show that every form of androgen deprivation therapy, including orchiectomy, increases a man's risk factors for heart disease.
Basaria says there's a clear benefit to androgen deprivation therapy for men with widely metastatic prostate cancer. And he notes that androgen deprivation therapy also prolongs life when used along with radiation therapy.
The questions arise, Basaria says, for men who had been in remission after treatment for prostate cancer, but who see their PSA levels rising -- a sign that prostate cancer may be coming back.
"Those may be the guys with whom a lot of discussion needs to be held with the oncologist, to discuss the advantages of androgen deprivation therapy in light of these risks," he says.