Prostate Cancer Treatment Can Speed Heart Attacks

Hormome-suppressing therapy linked to cardiac risk in study.

By Ed Edelson
HealthDay Reporter
Friday, June 8, 2007; 12:00 AM

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FRIDAY, June 8 (HealthDay News) -- The male hormone-suppressing treatment used against aggressive prostate cancer may help bring on earlier heart attacks in older men, new research suggests.

"The new finding is that in men who have risk factors for heart attack, even six months of androgen-suppression therapy [and] maybe as little as three months, can cause a heart attack to occur sooner by about 2.5 years," said lead researcher Dr. Anthony D'Amico, chief of genitourinary radiation oncology at the Dana-Farber Cancer Institute and Brigham and Women's Hospital in Boston.

That finding, which comes from analysis of pooled data of studies in the United States, Australia and New Zealand, does not mean that such men should not be treated to suppress the activity of androgens -- male sex hormones that spur the growth of prostate cancer cells, D'Amico said.

Instead, "the implication is that a man who needs hormonal therapy to avoid dying from cancer but also has risk factors for heart attack should be sent to a cardiologist for assessment and possible treatment of heart disease before starting hormonal therapy," he said.

"We're doing that," D'Amico said. He noted that, "of about 50 men we referred in the last six months, five or six had significant coronary artery disease. They have had it treated and have gone through hormonal therapy without being affected."

The findings are published in the June 10 issue of the Journal of Clinical Oncology.

Androgen suppression therapy (AST), as it is formally called, is reserved for men whose cancer is believed to have spread beyond the prostate or who have an aggressive form that is believed to have spread -- something that occurs in perhaps 40 percent of cases, D'Amico said. "You give these drugs to starve the prostate cancer, and it dies," he said.

Other side effects of AST are well-known. It can cause anemia, increase body fat, reduce muscle and cause an increase in harmful LDL ("bad") cholesterol and a decrease in helpful HDL ("good") cholesterol. But AST is also widely used, because it extends prostate cancer survival.