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Hormone Therapy for Prostate Cancer May Raise Risk of Kidney Injury

Jul 17, 2013

A new study has linked prostate cancer hormone-targeted therapy to kidney risks. The treatment, known as androgen deprivation therapy, is used to treat advanced or aggressive prostate cancer by slowing its progression. But for men who have a less advanced form of the disease, researchers are worried that the risks may outweigh the benefits.

The study, which was published in the Journal of the American Medical Association, involved 10,250 men diagnosed with prostate cancer between 1997 and 2008. The participants were followed for an average of about four years. "Our study does raise the concern that perhaps we should be more careful in prescribing androgen deprivation therapy in patients who do not have the clear indication for it… It's all about the balance, finding the right population for which the benefits clearly outweigh the risks," said Laurent Azoulay, one of the authors of the study. Overall, 232 men developed an acute kidney injury over the course of the study. An acute kidney injury is when there is a rapid drop in kidney function.

When other health conditions and medicines were taken into account, the researchers found that men taking androgen deprivation therapy were two to three times as likely to develop a kidney injury. Azoulay commented that a change in the levels of testosterone and estrogen may impact renal health and interfere with the kidneys’ ability to repair themselves.

Dr. Vahakn Shahinian, a professor who has studied the effects of hormone treatment at the University of Michigan in Ann Arbor who was not involved in the study, also commented on the findings. He told Reuters that the results were “interesting, but it certainly would require some kind of further validation” before confirming a definite effect. Still, Shahinian said that doctors should be wary about prescribing hormonal therapy.

The findings of this study suggest that in patients who do not have an absolute clear need for androgen deprivation therapy, it may present more risks than benefits. Shahinian highlighted this, stating that "Where there's a clear-cut benefit, people should continue to use it and not worry about this…it's in those settings where there's an uncertainty about the benefits that you have to be more worried about the side effects. And I think this adds to that list."

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