Though prostate cancer is the most common cancer among men and has a higher mortality rate, prostate cancer survivors are more likely to die from other factors such as cardiovascular disease, however not cancer, revealed a new study.
The study published in the Journal Circulation
reported that heart disease is the primary non-cancer cause of death for men with prostate cancer. The contributing factor for cardiovascular risk is androgen deprivation therapy (ADT) used for treating prostate cancer.
‘Ischemic heart disease is the most common non-cancer cause of death in patients with prostate cancer.’
"While ADT therapy is of great benefit to many patients with prostate cancer, it may also increase the risk of developing diabetes or having a heart attack or stroke. By collaborating with urology, medical oncology and the cardio-oncology program, we are better able to determine which patients are most likely to benefit from hormones, and in those who do get hormones, how to better protect their cardiovascular system," said Dr.Eric Shinohara, associate professor of Medicine and medical director of the Vanderbilt Radiation Oncology Clinic.
The authors have developed an algorithm called ABCDE that can help in evaluating prostate cancer survivors' risk of developing heart disease. The ABCDE algorithm includes awareness and aspirin, blood pressure monitoring, cholesterol management and cigarette avoidance, diet and diabetes, and exercise.
The study found an association between ADT and increased low-density lipoprotein and triglyceride levels, increased fat and decreased lean body mass, increased insulin resistance and decreased glucose tolerance, and a general metabolic state similar to metabolic syndrome.
"Aggressive treatment of these altered cardiovascular risk factors can be an important step to decrease the risk of heart attack and stroke in patients treated with ADT," said senior author Javid Moslehi, assistant professor of Medicine and director of Vanderbilt's Cardio-oncology program.
Reference: Javid Moslehi, et al. "Cardiovascular Effects of Androgen Deprivation Therapy for the Treatment of Prostate Cancer," Circulation, 2016; 133: 537-541, doi: 10.1161/CIRCULATIONAHA.115.012519.