Hormone therapy for prostate cancer may pose heart risks
(11 October 2009: VIDYYA MEDICAL NEWS SERVICE) -- The largest study of its kind indicates that hormone treatments used to block the effects of testosterone on prostate tumors can increase the risk of cardiac events and cardiac death. The retrospective study reviewed the health records of more than 30,000 Swedish men and found that the risk was highest in those men taking gonadotropin-releasing hormone (GnRH) agonists, the most commonly used hormone treatment in the United States. The results were reported at the ECCO 15-ESMO 34 conference in Germany.
The researchers looked at all men with prostate cancer in Sweden who were treated with hormone therapy between 1997 and 2006 and assessed their incidence of cardiac problems for 3 years after receiving the hormone treatment. The majority of patients received either GnRH agonists (which reduce testosterone production) or GnRH agonists plus anti-androgen drugs (which block testosterone from attaching to prostate cells). The remaining patients received anti-androgen therapy or orchiectomy (removal of the testicles).
According to study author Ms. Mieke Van Hemelrijck, treatment with any hormone therapy was associated with a 24 percent increase in the risk of a nonfatal heart attack and a 28 percent increase in risk of a fatal heart attack. The risks of heart failure, arrhythmia (irregular heart beat), and ischemic heart disease also increased, as did the risk of death from these cardiac problems. The lowest risk was associated with anti-androgen therapy, whereas GnRH agonists were associated with the highest risk.
The findings, stated Ms. Van Hemelrijck in a news release, “may have implications for treatment choice.”
Other studies have pointed to a potential increased risk for cardiac events associated with hormone therapy, explained Dr. Eric Horwitz, a radiation oncologist at Fox Chase Cancer Center. But that finding has not been consistent, he cautioned. “It’s hard to separate out this risk from patients’ other underlying health issues,” he said. For patients with aggressive disease, hormone therapy is very effective in conjunction with other therapies including radiation therapy and surgery. “But it’s a real risk,” he said. “It’s a discussion we’re now having every day with our patients.”
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