Prostate cancer treatment worse for heart disease patients

Prostate cancer patients with cardiovascular disease are far more likely to regret their treatment than cancer patients without heart problems, according to a US study.

Men with heart disease were more likely to suffer bowel and urinary problems that reduced their quality of life following cancer treatment.

Researchers said the findings bolster the ‘growing importance’ of considering the overall impact of treatment on a patient’s quality of life.

Active surveillance of prostate cancer instead of intervention could be considered when the cancer is less aggressive, they said.

A team from Harvard Medical School examined 795 men with recurrent prostate cancer and found that of the 15% of men who regretted their treatment, 52% had cardiovascular disease.

Regret was assessed by a questionnaire, in which patients were asked if they agreed with statements such as: ‘If I had known everything I could have known, I would still have chosen the same treatment approach for prostate cancer.’

Following primary cancer therapy, men with a cardiovascular comorbidity were 9% more likely to report bowel problems and 7% more likely to report urinary problems than men without cardiovascular disease.

The team suggest that their finding of greater regret in men with greater bowel toxicity ‘reinforces the notion that continued attention must be paid to ways of minimizing the toxicity of treatment’.

Patients with cardiovascular comorbidity may have a limited life expectancy and therefore regret having received any treatment that reduced their quality of life.

The study provides a rationale for men with cardiovascular comorbidity with less aggressive cancer to consider active surveillance, which aims to avoid or delay unnecessary treatment, instead of an intervention.

Researchers conceded that they were unable to determine whether men with cardiovascular disease regretted choosing the particular treatment or being treated for prostate cancer at all.

Lead author Dr Paul Nguyen said: ‘Some [patients] may subsequently regret their treatment if the outcomes after therapy do not meet their expectations.’

According to Dr Nguyen the research highlights ‘the growing importance of considering other health issues such as cardiovascular disease when counselling patients about prostate cancer treatment options’.

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