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Common Prostate Cancer Treatment May Be Less Risky Than Thought

But Concerns About ADT Treatment Remain for Heart Patients
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Fewer ADT-Treated Patients Died

Study participants were followed for as long as 15 years, with an average follow-up of about eight to 10 years.

During this time, 11% of the patients treated with ADT died of heart or blood vessel disease-related causes, compared to 11.2% of patients who did not get the treatment.

The age of the patients and how long they took the hormone therapy did not influence the findings, and men who took ADT had a 31% lower risk of dying from prostate cancer during the study than men who did not take the treatment.

They also had a lower overall risk of death, with 38% dying during the study, compared to 44% of the comparison-group patients.

“For the majority of men considering ADT for aggressive prostate cancer, these results should be reassuring,” the researchers write.

Tomaselli: Men With Heart Disease Should Be Followed Closely

The researchers add that the treatment-related risk isn’t clear for men with known heart disease or those who have had a heart attack.

American Heart Association President Gordon Tomaselli, MD, tells WebMD that the research as a whole emphasizes the importance of individualizing decisions about the use of ADT.

He adds that if the risk-benefit analysis favors using the treatment in patients with heart disease and stroke risk, these patients need to be followed very carefully to ensure that modifiable risk factors for heart attack and stroke, such as high blood pressure and cholesterol, are treated aggressively.

American Cancer Society Chief Medical Officer Otis Brawley, MD, says the most recent data on ADT treatment suggest that concerns about its use in men with existing heart disease are well warranted.

“About a third of men in the U.S. who are diagnosed with prostate cancer have a stroke at some point in their lives,” he tells WebMD. “There is an appropriate use for these treatments and an inappropriate use for them and I would be leery of using them in men who would not have qualified for these studies.”

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