Hormone therapy to treat prostate cancer increases risk of death from cardiovascular disease

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A population-based study of more than 13,000 patients showed that hormone therapy for prostate cancer increased the risk of death from cardiovascular disease, particularly in older men, according to an article published Thursday in the journal Aging Male. The highest risk was for coronary heart disease and stroke. The increased risks were apparent as early as the second year after cancer diagnosis and were more pronounced in older men.

“Hormone therapy is often used for patients with prostate cancer, but more research is now needed to better understand the overall risks and benefits of this treatment,” says lead author Justinas Jonusas of the National Cancer Institute of Lithuania. “Our results suggest that clinicians should consider cardiovascular disease risk reduction and mitigation strategies when developing a treatment plan for men diagnosed with prostate cancer, especially for older patients. old.”

Hormone therapy, also known as androgen deprivation therapy, is a basic treatment for patients with prostate cancer. Treatment uses surgery or medication to lower levels of hormones (such as testosterone) in the body that fuel cancer growth. Previous research has suggested that hormone therapy may increase the risk of negative cardiovascular outcomes, other studies have found no such link, leaving the relationship between prostate cancer treatment and cardiovascular disease unclear.

In the study, researchers used data from the Lithuanian Cancer Registry to identify 13,343 men between the ages of 40 and 79 who were diagnosed with prostate cancer between 2012 and 2016. They compared the risk of death from cardiovascular disease in the 3,797 patients who had received anti-hormonal treatment. medication and 9,546 who had none. The average duration of follow-up for the group treated with hormone therapy was 4.63 years and 5.13 years for those who were not.

After making appropriate adjustments to the data, the researchers found:

  • a more than double increase in the risk of death from cardiovascular disease in men who received hormone therapy.
  • a higher risk of death from cardiovascular disease from the second year following a diagnosis of prostate cancer.
  • an almost five times higher risk in the 70 to 79 age group of those who received hormone therapy compared to those who did not.
  • The team also assessed the risk of death from several subtypes of cardiovascular disease, identifying that there was a higher risk of dying specifically from stroke or coronary heart disease. These risks were respectively 42% and 70% higher in men treated with hormone therapy than in those who were not.

“Prostate cancer is usually diagnosed in older men, over the age of 65, and many of them have already been diagnosed with cardiovascular disease,” Jonusas said. “It is therefore concerning that we have found such a dramatic increase in the risk of death from cardiovascular disease in older men receiving hypohormonal drugs. Therefore, we would like to express our view that this group of patients should be subject to screening for pre-existing cardiovascular diseases and their risk factors to minimize the risk of dying from these conditions.

This is the first study to analyze hormone therapy-induced cardiovascular mortality in a national cohort, based on real data.

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