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 medicine hat news paper
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 medicine hat news obituary
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.
The new medicine news
on the treatment's adverse cardiac effects comes
from analysis of data from 1,372 men who received radiation treatment plus
AST in three randomized trials and who were followed for at least five
years.
A faster onset of heart attacks was observed in men over 65 who got AST
for six months, the researchers found.
“This is one more reason to be careful when you recommend hormone
therapy,” said Dr. Eric M. Horwitz, clinical director of radiation
oncology at Fox Chase Cancer Center in Philadelphia. “They do have cardiac
side effects.”
But AST will continue to be used in many cases, he added. “There is
clearly a group of men where the benefits outweigh the risks,” he said.
“This study shows that you have to weigh the pros and cons of the
treatment, who gets benefits and who doesn't.”
Men who benefit most are those with “aggressive, bulky prostate
cancers,” according to Horwitz. “The benefits for them still outweigh the
risk in terms of trying to cure the cancer. For men with less aggressive,
less bulky cancers, you have to weigh the benefits versus the risks.”
Other efforts to get the best effect from AST while minimizing the
damage are under way, D'Amico said. One method under study is to stop the
treatment now and then. “For advanced prostate cancer, we don't expect to
keep the treatment going forever,” he said. “You can make it intermittent
to get the same survival with less toxicity — six months on and six
months off,” he said.
Also, some studies indicate that a shorter course of AST can be
effective with fewer side effects — at least for some patients, D'Amico
said. “We need to be better at selecting men for therapy and directing its
course,” he said.
More information
A guide to prostate cancer is offered by the American Cancer Society.
|
Leave a Comment
You must be logged in to post a comment.