Prostate Cancer Hormone Therapy Linked To Blood Clots

Prostate cancer hormone therapy has been linked to blood clots, according to a large United States five-year study in a review of over 154,000 older men with prostate cancer.

Researcher learned that of the men studied, those receiving hormone therapy also experienced double the rate of blood clots in the veins, arteries, or lungs versus men who were not on hormone therapy, said Reuters. Of the approximately 58,000 men on hormonal therapy, 15% developed a blood clot over a four-year period; in the group not taking hormone therapy, only 7% developed a blood clot, said Reuters. It remains unknown how hormone therapy increases blood lot risks.

Of the men who developed a blood clot, about 25% required hospitalization, said the researchers, reporting in the journal, Cancer. Of note, said Reuters, a blood vessel clot can be deadly if the clot breaks loose and reaches the lungs, heart, or brain. “By no means is this a trivial risk,” said lead author Dr. Behfar Ehdaie, of Memorial-Sloan Kettering Cancer Center in New York. Benefits must be weighed against risks, Dr. Ehdaie pointed out. Weight gain, bone thinning, hot flashes, and erectile dysfunction are among the other risks.

Traditionally only given to men in advanced stage, metastasized prostate cancer, hormone therapy provides symptom relief and reduces the body’s production of the male hormone, testosterone, explained Reuters. Hormone therapy can also increase survival rates when prescribed along with radiation therapy in men whose cancer is deemed likely to progress.

“Those are the two scenarios where there is clear-cut evidence of a benefit,” said Dr. Vahakn B. Shahinian, of the University of Michigan in Ann Arbor, who wrote an editorial published with the study. “The issue comes when you look at the host of other scenarios where hormone therapy is used,” Dr. Shahinian added, said Reuters.

For instance, some physicians have been using hormone therapy on male patients recently diagnosed with tumors that have not spread beyond the prostate, even though the benefits for these patients have not been established, said Reuters. Some of these men may not be in optimal health and the more aggressive treatment might not be in their best health interests; however, the doctor or patient may feel they have to do something, said Dr. Shahinian, wrote Reuters.

Dr. Ehdale said that finances might be involved, as well. As of 1999, hormone therapy was prescribed to roughly half of the prostate cancer patients; however, recent studies reveal that recent Medicare reimbursement cuts involving this therapy have forced doctors to seek alternative treatments, according to Reuters.

According to the National Cancer Institute, about 190,000 men in the United States are diagnosed with prostate cancer. In 2009, about half of these men fell into the lower risk category in which hormone therapy was not called and diagnosis involved low progression rates, explained Reuters.

As the Sydney Morning Herald noted, while prostate cancer treatments help extend life, some can adversely impact quality of life with reactions that are uncomfortable, bothersome, and impacting day-to-day activities as well as some dangerous reactions, such as blood clotting.