Prostate Cancer Therapies Raise Heart Risk
But Study Shows Some Anti-Hormone Treatments Are Less Risky Than Others
Measuring Risk of Prostate Cancer Treatments continued...
Overall, anti-hormone therapies were associated with a 24% increased risk of heart attack, a 19% increased risk of irregular heartbeats known as arrhythmias, a 31% increased risk of ischemic heart disease, and a 26% increased risk of heart failure. The risks began to climb within a few months of starting hormone therapy.
Prostate cancer patients treated with anti-hormone therapies also had a 22% to 41% higher chance of dying of a heart attack or other type of heart disease, compared with the general population.
But further analysis showed that while all three forms of anti-hormone therapy were associated with an increased risk for heart disease, anti-androgens were associated with the lowest risk." Patients on gonadotropin-releasing hormone agonist therapy had the highest risk of these problems," Van Hemelrijck says.
For example, men given anti-androgen pills had a 15% increased chance of developing ischemic heart disease vs. a 33% increased risk in the men who received gonadotropin-releasing hormone agonists.
Since men given anti-androgens still have circulating testosterone in the body, the findings "support support the hypothesis that testosterone is protective for the heart," Van Hemelrijck says.
Risks vs. Benefits
While the study does not prove that anti-hormone drugs cause heart ills, "they show the importance of taking heart disease into account when considering anti-hormone therapy, especially since it is now being given to men with earlier-stage disease," she adds.
While increased, the risks are still low in absolute terms, says ESMO President Jose Baselga, MD, chairman of the medical oncology service at the Vall d'Hebron University Hospital in Barcelona, Spain.
For example, the researchers estimated that anti-hormone therapies cause an extra one heart problem per year for every 100 prostate cancer patients treated, he notes.
"Untreated, advanced prostate cancer is a lethal condition. For most men, the benefits of anti-hormone therapy ultimately outweigh the increased risk of heart problems," Baselga says.
That said, he and Van Hemelrijck agree that men at risk for heart disease should talk to their doctor and undergo a through heart health exam before starting anti-hormone treatment.