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Prostate Cancer Drugs Linked to Increased Risk of Heart-Related Deaths

Oct 31, 2014

A new study has found that some prostate cancer medications increase the risk of dying from heart-related causes in men with congestive heart failure or prior heart attacks.

The study will appear online in BJU International, a urology journal. Androgen deprivation therapy (ADT) reduces levels of male hormones in the body to prevent them from stimulating cancer cells. ADT is a mainstay of treatment for prostate cancer. But ADT has been associated with heart problems, coronary heart disease, heart attacks, sudden cardiac death, and increased risk of diabetes. To thoroughly investigate the potential link, Dr. Paul Nguyen of the Dana-Farber/Brigham and Women's Cancer Center in Boston, and his colleagues analyzed information on 5,077 men treated for prostate cancer between 1997 and 2006. Thirty percent of the men received ADT, while the others did not, according to a news release from Wiley, the journal’s publisher.

No association was detected between ADT and heart-related deaths in men with no cardiac risk factors (1.08 percent at five years for ADT versus 1.27 percent at five years for no ADT) or in men with diabetes, hypertension, or high cholesterol (2.09 percent vs. 1.97 percent). But ADT was associated with a 3.3-times increased risk of heart-related deaths, in men with congestive heart failure or prior heart attacks, according to the news release. After five years, in this subgroup, heart-related deaths occurred in 7.01 percent of men receiving ADT versus 2.01 percent of men not receiving ADT.

"While androgen deprivation therapy can be a lifesaving drug for men with prostate cancer and significantly increase the cure rates when used with radiation for aggressive disease, this study also raises the possibility that a small subgroup of men who have significant heart disease could experience increased cardiac death on ADT," said Dr. Nguyen. He noted that because this is a retrospective study, the findings must be weighed against larger controlled trials that have demonstrated the benefits of ADT. Dr. Nguyen said "for men with significant heart problems, we should try to avoid ADT when it is not necessary—such as for men with low-risk disease or men receiving ADT only to shrink the prostate prior to radiation.”

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