ADT Therapy for Prostate Cancer Can Increase Heart
Risk Factors
Androgen-deprivation therapy (ADT) may increase
cardiovascular risk, but unclear whether its linked to increased death
from heart disease
Feb. 3, 2010 - Androgen-deprivation therapy (ADT),
commonly used to treat prostate cancer, can worsen heart risk factors
and may increase the risk of heart attack and/or cardiac death, although
the relationship between ADT and heart attack or cardiac death has not
been definitively established, according to a science advisory published
in Circulation: Journal of the American Heart Association and
CA: A Cancer Journal for Clinicians.
The advisory, produced by a writing group of
experts from the American Heart Association, American Cancer Society and
American Urological Association, and endorsed by the American Society
for Radiation Oncology, is an evaluation of published research about the
relationship between ADT and cardiovascular events and risk factors in
patients with prostate cancer.
Considerable data show that ADT can increase fat
mass, increase low-density lipoprotein (LDL) cholesterol the bad
cholesterol and cause blood sugar abnormalities, according to the
writing group.
Based on current data, it was appropriate to
conclude that there may be a relationship between ADT therapy in
patients with prostate cancer and future cardiovascular risk, said
Glenn N. Levine, M.D., chair of the advisory writing group and professor
of medicine at Baylor College of Medicine in Houston.
While some studies have found an association
between ADT and increased cardiovascular risk, other studies have not
detected the association, according to the advisory. The writing group
called for future studies to prospectively analyze heart risks related
to ADT whenever possible.
An increased risk with ADT was noted in 1 percent
to 6 percent of the study populations. Thus, while there may be some
increased heart risk, the decision about whether to initiate ADT should
be based on weighing the benefits of therapy with this potential modest
risk, he said.
Decisions about ADT should be made by the physician
treating the patient for prostate cancer without referral to other
specialists, according to the advisory. However, given the metabolic
effects of ADT therapy, patients receiving ADT should be followed
periodically by their primary care physicians.
Patients with known heart disease should always be
encouraged to adopt healthy lifestyle changes and receive the
appropriate preventive therapies if necessary, including lipid-lowering,
blood pressure-lowering, glucose-lowering therapy and antiplatelet
therapies (such as aspirin), Levine said.
Co-authors include: Anthony V. DAmico, M.D.,
Ph.D.; Peter Berger, M.D.; Peter E. Clark, M.D.; Robert H. Eckel, M.D.;
Nancy L. Keating, M.D., M.P.H.; Richard V. Milani, M.D.; Arthur I.
Sagalowsky, M.D.; Matthew R. Smith, M.D., Ph.D.; and Neil Zakai, M.D.
About the American Urological Association Founded in 1902 and headquartered near Baltimore, Maryland, the American
Urological Association is the pre-eminent professional organization for
urologists, with more than 16,000 members throughout the world. An
educational nonprofit organization, the AUA pursues its mission of
fostering the highest standards of urologic care by carrying out a wide
variety of programs for members and their patients. For more
information, please call 1-866-RING-AUA (1-866-746-4282) or visit
www.AUAnet.org.
About the American Cancer Society The American Cancer Society saves lives and creates a world with less
cancer and more birthdays by helping you stay well, helping you get
well, by finding cures and fighting back. As the nations largest
non-governmental investor in cancer research, contributing about $3.4
billion, we turn what we know about cancer into what we do. To learn
more about us or to get help, call 1-800-227-2345 or visit
www.cancer.org.
About the American Heart Association Founded in 1924, were the nations oldest and largest voluntary health
organization dedicated to building healthier lives, free of heart
disease and stroke. To help prevent, treat and defeat these diseases
Americas No. 1 and No. 3 killers we fund cutting-edge research,
conduct lifesaving public and professional educational programs, and
advocate to protect public health. To learn more or join us in helping
all Americans, call 1-800-AHA-USA1 or visit
www.americanheart.org.
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