Heart attack risk is increased by some prostate cancer treatments

Patients who have suffered a heart attack and plan to undergo prostate cancer treatment, may want to weigh the risks and benefits of androgen deprivation therapy (ADT). ADT decreases the amount of androgens in the body, which prostate cancer needs to grow and survive. This therapy is also often used in combination with radiation therapy. The combination of these two therapies has been shown to prolong survival in men with unfavorable-risk prostate cancer—defined as cancer with two or more high-risk factors, such as a PSA level between 10 and 40 ng/mL, a Gleason score of 7 or higher, or biopsies with 50% or higher cancerous cells.

A study in The Journal of the American Medical Association suggests that men who had a prior heart attack can experience increased risks of having another fatal heart attack if they undergo both radiation therapy and ADT.

Researchers compared overall survival and death from prostate cancer, fatal heart attack, and other causes in a group of 206 men with unfavorable-risk prostate cancer. The men received either radiation alone, or radiation and six months of ADT. The researchers also categorized the men into subgroups based on other health conditions, including heart disease.

After a 16-year follow-up, researchers found that among the subgroup who had a previous heart attack, treatment with both radiation and ADT reduced their 15-year survival rate to 8%, compared with 20% for those who were treated only with radiation.

These findings may suggest that doctors should rethink using this combination of therapies on men with known heart disease.

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