Using hormone therapy to treat prostate cancer may require more attention from health care providers as new research shows the therapy may increase the risk of heart disease.
Men — and especially older men — with prostate cancer are at an increased risk of death from heart disease with hormone therapy, according to the results of a study conducted in Lithuania and published in The aging man.1
“Hormone therapy is commonly used for patients with prostate cancer, but more research is now needed to better understand the overall risks and benefits of this treatment,” says study author Justinas Jonusas, MD, of the National Cancer Institute in Lithuania. , in the press release.1
The hormone therapy used to treat prostate cancer is androgen deprivation therapy (ADT), which can help lower the levels of testosterone in the body, which can cause prostate cancer by stimulating excessive cell growth.1.2 According to the authors of the study, previous research has suggested that there are adverse effects of hormone therapy on cardiovascular health, but not enough studies have been done to link hormone therapy to prostate cancer and cardiovascular disease.1
“There are instances where it’s clear that men need hormone therapy,” William Dahut, MD, a prostate cancer researcher and chief scientific officer of the American Cancer Society, said in the press release.2 “But often it’s used for patients who are newly diagnosed, who are receiving radiation, or in men with a rising PSA [prostate specific antigen] without cancer that we can see, something called biochemical recurrence.”2
During the study, researchers used data from the Lithuanian Cancer Registry to identify male patients, ages 40 to 79, who were diagnosed with prostate cancer between 2012 and 2016.2 To determine the risk of death from heart disease, they compared 3,797 patients who had received hormone-lowering drugs and 9,546 patients who had not. About 5 years later, the researchers followed up the patients.1
Based on the results, the researchers found that there was a 2-fold increase in the risk of death from cardiovascular disease in the group receiving hormone therapy.1 They also noted that the risk of death increased after the second year of cancer diagnosis, along with a 5-fold increased risk for patients over age 70.1
For men treated with hormone therapy, the risk of death from cardiovascular disease subtypes increased, with a 42% increased risk of death from stroke and a 70% increased risk of death from coronary artery disease.1
“Prostate cancer is usually diagnosed in older men, over the age of 65 – and many of them will already have been diagnosed with cardiovascular disease. It is therefore worrying that we have such a massive increase in the risk of death from cardiovascular disease found in older men receiving hormone-lowering drugs,” Jonusas said in a press release.1
In addition, Jonusas noted that screening for pre-existing cardiovascular disease and risk factors may help minimize the risk of death from heart disease in especially older men.1
However, other cancer treatments may also increase cardiovascular risk, Katelyn Atkins, MD, PhD, a radiation oncology specialist at Cedars-Sinai Cancer Institute in Los Angeles, said in the press release.2 However, when it comes to cancer, health care providers can treat patients despite these increased risks.2
To address this issue, Dahut explained that patients should be treated with ADT and other cancer treatments on a case-by-case basis to determine risk, specifically noting that further research was needed to support this process.
“If we can do research to differentiate those populations, it will make the discussions much easier for patients and their doctors,” Dahut said.2
- Hormone therapy for prostate cancer increases the risk of dying from cardiovascular disease. Taylor & Francis Group; July 27, 2022. Accessed July 27, 2022. https://www.eurekalert.org/news-releases/959617
- Murez C. Prostate cancer treatment may increase heart risks. American news. July 27, 2022. Accessed July 27, 2022. https://www.usnews.com/news/health-news/articles/2022-07-27/prostate-cancer-treatment-may-raise-heart-risks