Risks of Hormone Therapy for Prostate Cancer
Study Shows Prostate Cancer Treatment May Be Risky for Patients Who Also Have Heart Disease
Aug. 25, 2009 - Prostate cancer patients with established heart disease have an increased risk of dying when they receive hormone therapy prior to radiation, a new study suggests.
Patients with a history of heart attack or congestive heart failure related to coronary artery disease who were treated with hormone therapy prior to radiation had twice the risk of death during the study as patients with the same heart history who did not have hormone therapy.
The study appears in the Aug. 26 issue of TheJournal of the American Medical Association.
Hormone therapy, known medically as androgen deprivation therapy, can be given to shrink tumors and slow tumor growth before radiation treatment. The approach has been shown to improve survival in men with advanced or poor-prognosis prostate cancer.
But in several recent studies, this survival benefit did not exist in patients with other medical conditions such as diabetes, high cholesterol, and high blood pressure.
In an effort to better understand the impact of hormone therapy on survival in prostate cancer patients with these risk factors or a history of heart disease, researchers followed more than 5,000 patients for up to a decade.
All the study participants were treated at the same Chicago prostate cancer center with brachytherapy, which involves the implantation of radioactive seeds within the tumor to allow the delivery of higher and more targeted doses of radiation.
Some of the men in the study received four months of hormone therapy prior to radiation treatment and others had radiation without prior hormone therapy.
Just over 400 of the men died during follow-up and about half of those men had no other medical conditions. The rest had at least one risk factor for heart disease or established coronary artery disease leading to congestive heart failure or a previous heart attack.
Hormone Therapy and Heart Disease
Hormone therapy had no significant impact on death rates in men who had no other known illnesses or who had a single risk factor (diabetes, high blood pressure, or high cholesterol) for heart disease. Smoking history and family history of heart disease were not evaluated in this study.