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Prostate cancer therapy increases risk of fractures and cardiovascular-related death
April 27, 2009Prostate cancer patients who undergo therapy to decrease testosterone levels increase their risk of developing bone- and heart-related side effects compared to patients who do not take these medications, according to a new analysis. Published in the June 1, 2009 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the study indicates that preventive measures and careful scrutiny of patients' health can keep men from experiencing these potentially serious consequences.
While medical treatments that decrease testosterone levels-called androgen deprivation therapy (ADT)-are important and effective therapies for men with prostate cancer, they can cause a variety of side effects including skeletal and cardiovascular complications, sexual dysfunction, periodontal disease, and mood disorders.
Bone and heart complications are among the most serious side effects associated with ADT, but the actual risk patients have of developing these effects is unknown. Lockwood Taylor, MPH, of the University of Texas Health Science Center and colleagues conducted a study to assess this risk by analyzing all of the literature related to side effects from ADT published between 1996 and mid-2008. They found 14 studies (8 bone-related, 6 heart-related) that were suitable for analysis.
The researchers' review revealed that men treated with ADT for prostate cancer had an increased risk of bone fractures and heart-related death, although the absolute risk for both was still low. For bone fractures, there was a 23 percent increased risk compared to prostate cancer patients who did not undergo the treatment. The absolute risk of fracture among ADT-exposed men was still only 7.2 per 100 person years. For heart-related death, the increased risk among ADT-exposed men was 17 percent higher compared to other prostate cancer patients. However, because the baseline risk is low, the increase translated to an additional one-to-two deaths per 1,000 men who received ADT. Two large studies also documented significant increases in diabetes risk associated with the therapy.
"While the absolute risks of fracture and cardiovascular mortality are low among men treated with androgen deprivation therapy, preventive treatments may further reduce the risk of these serious adverse outcomes related to androgen deprivation therapy," the authors wrote. They also noted that because some patients may benefit from this therapy more than others, physicians should consider each patient's overall health and prostate cancer status when weighing treatment options.
American Cancer Society
The researchers' review revealed that men treated with ADT for prostate cancer had an increased risk of bone fractures and heart-related death, although the absolute risk for both was still low. For bone fractures, there was a 23 percent increased risk compared to prostate cancer patients who did not undergo the treatment. The absolute risk of fracture among ADT-exposed men was still only 7.2 per 100 person years. For heart-related death, the increased risk among ADT-exposed men was 17 percent higher compared to other prostate cancer patients. However, because the baseline risk is low, the increase translated to an additional one-to-two deaths per 1,000 men who received ADT. Two large studies also documented significant increases in diabetes risk associated with the therapy.
"While the absolute risks of fracture and cardiovascular mortality are low among men treated with androgen deprivation therapy, preventive treatments may further reduce the risk of these serious adverse outcomes related to androgen deprivation therapy," the authors wrote. They also noted that because some patients may benefit from this therapy more than others, physicians should consider each patient's overall health and prostate cancer status when weighing treatment options.
American Cancer Society
Prostate Cancer Current Events and Prostate Cancer News RSSDoes prostate-specific antigen velocity help in early detection prostate cancer?
The November issue of European Urology, the official journal of the European Association of Urology, features an article focussing on prostate specific antigen (PSA) velocity and early cancer detection. It has been suggested that changes in PSA over time aid prostate cancer detection.
New Synthetic Molecules Trigger Immune Response to HIV and Prostate Cancer
Researchers at Yale University have developed synthetic molecules capable of enhancing the body's immune response to HIV and HIV-infected cells, as well as to prostate cancer cells. Their findings, published online in the Journal of the American Chemical Society, could lead to novel therapeutic approaches for these diseases.
Chemo-radiation before prostate removal may prevent cancer recurrence
Researchers in the Oregon Health & Science University Knight Cancer Institute and the Portland Veterans Affairs Medical Center have found a combination of radiation therapy and chemotherapy given before prostate removal is safe and may have the potential to reduce cancer recurrence and improve patient survival.
Blood vessels might predict prostate cancer behavior
A diagnosis of prostate cancer raises the question for patients and their physicians as to how the tumor will behave. Will it grow quickly and aggressively and require continuous treatment, or slowly, allowing therapy and its risks to be safely delayed?
Short-term hormone therapy and intermediate dose radiation increases survivial for early stage prostate cancer
Short-term hormone therapy given prior to and during intermediate dose radiation treatment for men with early stage prostate cancer increases their chance of living longer, compared to those who receive the same radiation alone.
Task force develops new radiation guidelines for brachytherapy
Radiation dose delivered to the prostate and nearby organs in every brachytherapy procedure should be carefully analyzed using post-implant CT or MRI and uniformly documented in every patient.
1 disease, not 1 demographic
The Asian continent has nearly four billion people living in 47 different countries, and each of these groups has their own unique set of health issues. But when they come to the United States, they're often lumped into one large demographic: "Asian/Pacific Islander."
Cancer survivors may not be getting the help they need to stop smoking
More than a quarter of cancer survivors who still smoke have not been advised to quit smoking by their health care providers in the last year, according to a study published by researchers at Fox Chase Cancer Center in the current issue of the Journal of General Internal Medicine.
Experts issue call to reconsider screening for breast cancer and prostate cancer
Twenty years of screening for breast and prostate cancer - the most diagnosed cancer for women and men - have not brought the anticipated decline in deaths from these diseases, argue experts from the University of California, San Francisco and the University of Texas Health Science Center at San Antonio in an opinion piece published in the "Journal of the American Medical Association."
Detecting the undetectable in prostate cancer screening
A team of Northwestern University researchers, using an extremely sensitive tool based on nanotechnology, has detected previously undetectable levels of prostate-specific antigen (PSA) in patients who have undergone radical prostatectomy.
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