Prostate cancer therapy doesn’t increase cardiovascular deaths, study says

A prostate cancer treatment called androgen deprivation therapy has been somewhat controversial because of fears that the medications involved may raise the risk of death from cardiovascular causes, such as heart attacks. But a new analysis did not find that association.

Androgen deprivation therapy involves the use of medications that suppress production of male sex hormones that may otherwise fuel cancer growth. It’s a popular treatment for prostate cancer despite the fact that the Food and Drug Administration in 2010 required labeling on the medications to warn of an increased risk of diabetes and cardiovascular disease. The warning was spurred by some studies that showed an increased risk, although other studies did not indicate a problem.

In the new analysis, researchers led by Dr. Paul L. Nguyen of the Dana-Farber Cancer Institute looked at eight randomized clinical trials on such therapy. They found 255 cardiovascular deaths among a group of 2,200 patients treated with androgen deprivation therapy compared with 252 such deaths in a control group of 1,941 patients.

The men who received androgen deprivation therapy had a 31% lower relative risk of dying from prostate cancer compared with men treated with other therapies.

However, the analysis could not stratify patients by pre-existing cardiovascular disase. That means there may be a small group of men with heart disease who experience an increased risk of cardiovascular death by taking androgen deprivation therapy.

Men on androgen deprivation therapy who also have heart disease should follow measures to prevent cardiac trouble, such as controlling blood sugar and taking cholesterol-lowering and anti-hypertensive medications, said the authors of a commentary accompanying the study, published Tuesday in the Journal of the American Medical Assn.

“Although androgen deprivation therapy has been part of the treatment regimen for several decades, clinicians treating patients with prostate cancer are still understanding the short-term and long-term biological effects. . .” they wrote.

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