Cardiovascular disease (CVD) and metabolic risks are linked to ADT in men with prostate cancer. Androgen deprivation therapy (ADT) is a treatment for prostate cancer, which is the most common form of cancer in men and is the second leading cause of cancer-related deaths in the U.S. Prostate cancer can be a slow process, but if caught early enough, treatment can more effective.
ADT is used for locally advanced and metastatic prostate cancer. Much research has uncovered a link between ADT and a higher risk of cardiovascular conditions. It is important that the link between ADT and CVD is better understood in order to prevent heart-related complications.
Heart disease risk in prostate cancer patients on ADT
The FDA has expressed that any ADT treatment labels should report an increased risk of cardiovascular disease and diabetes in prostate cancer patients. The warnings come from population-based studies that explored the risk of cardiovascular disease. Although a link has been found between ADT and CVD, it is still very much unclear as to how ADT increases the incidence of cardiovascular disease.
A Swedish study found that men with a history of cardiovascular disease prior to using ADT are at risk for cardiovascular disease within the first six months of ADT treatment. The researchers looked at 41,362 men with prostate cancer and treated with ADT. The men were compared to 187,785 prostate cancer-free men.
The prostate cancer patients were treated with anti-androgens or GnRH agonists, or underwent surgical orchiectomy. The men who were treated with GnRH had a 21 percent greater risk of developing cardiovascular disease, compared to the controls. Men who underwent the orchiectonomy had a 16 percent increased risk of cardiovascular disease. The men taking anti-androgens still had a 13 percent lower risk of cardiovascular disease.
The risk of cardiovascular disease was highest within the first six months of treatment in men with a prior history of cardiovascular disease. The study authors concluded, “There should be solid indication of use of ADT so that the perceived benefit outweighs possible harm. This is particularly important in men with a recent history of cardiovascular disease.”
In an accompanying editorial, Shehzad Basaria wrote, “There is a large body of data showing worsening of the metabolic profile in men undergoing ADT.”
Steps to reduce CVD risks in prostate cancer patients
Although there is still much more research required to better understand the relationship between ADT and cardiovascular disease, there are steps you can currently take in order to reduce your risk of cardiovascular disease while receiving ADT treatment for prostate cancer.
- Speak to your doctor about taking a daily aspirin.
- Manage your blood pressure.
- Treat high cholesterol with statins.
- Stop smoking.
- Manage and treat diabetes.
- Stick to a healthy and well-balanced diet.
- Exercise regularly.
By working closely with your doctor, both of you can come up with an appropriate treatment plan for prostate cancer, along with reducing your risk of cardiovascular disease.