Heart risk higher for older men undergoing this treatment

By Mark Waghorn via SWNS

Older men undergoing testosterone-lowering therapy for prostate cancer are up to five times as likely to die from cardiovascular disease, according to new research.

Patients should be screened for heart, artery and blood vessel health before beginning, say scientists.

Androgen deprivation therapy (ADT) uses surgery or medicines to lower levels of male hormones, such as testosterone, that are made in the testicles.

A large-scale study found cardiovascular disease mortality rates more than doubled in those given it - rising almost fivefold among 70 to 79-year-olds.

Lead author Dr. Justinas Jonusas, of the National Cancer Institute in Lithuania, said: "Prostate cancer is typically diagnosed in older men, over 65 years or older - and many of them will have already been diagnosed with cardiovascular disease.

"It is therefore concerning we found such a tremendous increase in the risk of cardiovascular disease-related death in elderly males receiving hormone-lowering drugs.

"Consequently, we would like to express our notion that this group of patients should be screened for pre-existing cardiovascular disease and their risk factors to minimize the risk of dying from these conditions."

The increased risks were apparent from the second year after cancer diagnosis - and more pronounced in older men. Coronary heart disease and stroke were most common.

Dr. Jonusas said: "Hormone therapy is often used for patients with prostate cancer, but more research is now needed to gain a better understanding of the overall risks and benefits of this treatment.

"Our results suggest clinicians should consider risk reduction and mitigation strategies for cardiovascular disease when developing a treatment plan for men diagnosed with prostate cancer, particularly for older patients."

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

Some previous investigations had suggested a link, while others had not - leaving the relationship unclear.

Dr. Jonusas and colleagues used the Lithuanian cancer registry to identify 13,343 patients aged 40 to 79 who were diagnosed between 2012 and 2016.

They compared the risk of death from cardiovascular disease among the 3,797 patients who had received hormone-lowering drugs and 9,546 who had not. They were tracked for an average of around five years.

The team also assessed the risk of death from several types of cardiovascular disease, identifying there was a higher risk of dying specifically from stroke or coronary heart disease.

These risks were 42 percent and 70 percent higher, respectively, in men treated with hormone therapy compared to those who were not.

Prostate cancer is the most common male cancer globally.

The study is in The Aging Male. ADT has also been found to double the risk of being diagnosed with Alzheimer's.