cancer is the second most common cancer in men globally
hormones in the body cause prostatic cancer cells to multiply, grow and
therapy (suppression of androgens) is one of the main treatments for
therapy for prostate cancer is associated with an increased risk of heart-related
deaths, especially in men with a prior history of heart attack.
risks versus benefits of treatment must be carefully considered before
initiating hormone treatment.
Men who were given hormonal treatment for
have an increased risk of dying of
heart disease, especially if they had an earlier history of heart attack
. These findings were the result of a
recently conducted Yale Cancer Center team study.
of The Study
The researchers analyzed data from a
decision analysis model that had done a comparison of quality-adjusted life years (QALYs) in men aged 50, 60, and 70 years
who were given radiation therapy but no hormone therapy
for high-risk prostate cancer
and their cardiac risk factors. The research
team studied data from a recently published EORTC 22991 trial that assessed men
with intermediate-risk prostate cancer randomly chosen to receive either
radiation therapy or radiation therapy plus 6 months hormone therapy.
‘Risks of hormone therapy for prostate cancer must be weighed against its benefits, especially in men with a previous history of heart attack.’
Of The Study
- Study participants (men) with a prior history of heart attack who
received hormone therapy showed a net reduction of 0.3 - 0.4 QALYs.
However, hormone therapy improved QALYs (range 0.4 - 2.6) in other men.
men who had fewer cardiac risk factors demonstrated the highest advantage
from hormone therapy.
prostate cancer or in other words were at a reduced risk for biochemical
(PSA) failure (≤8.7% at 5 years) did not quite benefit from hormone
therapy. Furthermore, the beneficial effects of hormone therapy did not
begin to show up till more than 7.3 years of follow-up.
Cancer of the prostate gland
develops in men older than 65 years. It is the second most common cancer in men
Initially the disease may not
show any symptoms, but larger growths may typically cause urinary symptoms such
need to empty the bladder
visits to the toilet
hard to pass urine, but only a few drops come out.
feeling of incomplete emptying of the bladder after passing urine
Prostate cancer spreads typically to the
bones and may cause pain in back, hips, and pelvis.
Prostate cancer is characterized by markedly elevated levels of a protein
called prostate specific antigen (PSA) in the blood
The available main modalities of treatment for prostatic cancer include
surgery, radiotherapy and hormone therapy
About Hormone Therapy
Prostate cancer grows and spreads under
the influence of the male hormone testosterone (androgen). Hormone therapy
therefore involves giving drugs to suppress the patient's androgens, and is
termed Androgen Deprivation Therapy
of whether or not to administer hormone therapy depends on
the grade and stage of cancer
effects of hormone therapy
- Erection problems: Common side effect of hormone
therapy for prostate cancer
- Hot flashes and sweating
- Loss of interest in sex
- Breast enlargement and tenderness
- Tiredness and fatigue
Additionally, more relevant to this
study, hormone treatment leads to an increased risk for development of heart disease, diabetes and stroke
To Be Learnt From The Findings of The Study
It is thus evident that men with prostate
cancer who already have a history of heart disease are at an increased risk of
dying from heart disease related causes following hormone therapy for their
of androgen deprivation therapy (ADT) must be carefully considered
deciding on this line of treatment. In men with heart disease, who have low-risk prostate cancer, ADT
could be avoided. However, in men with heart disease who have high-risk prostate cancer, ADT
may still be considered if the benefits of therapy outweigh the risks,
following which patient would require regular follow up by a heart specialist
It will be fitting to conclude with the remarks made by one of the researchers
of this study - "Patient age, cardiac risk, and disease recurrence risk should
be considered when selecting candidates for hormone therapy in this patient
[prostate cancer] population," said Nataniel Lester-Coll, MD, first author on
the study and a Resident in the Department of Therapeutic Radiology at Yale
School of Medicine. "Men with a history of heart attack who are at very low-risk for biochemical
failure may [actually] be harmed by the addition of hormone therapy."
- Side Effects of Hormone Therapy for Prostate Cancer - (http://www.cancerresearchuk.org/about-cancer/type/prostate-cancer/treatment/hormone/side-effects-of-hormone-therapy-for-prostate-cancer)