Prostate therapy is linked to heart risk

Using androgen deprivation therapy (ADT) to treat prostate cancer could double the risk of death from heart disease, US researchers have claimed.

ADT is used to treat high-risk localised prostate cancer and has proved effective in improving survival rates.

For the study, the researchers collected data on 3,262 patients treated by surgical removal of the prostate and 1,630 patients treated with radiation therapies. Of these patients, 1,015 were also treated with ADT.

Over a four-year follow-up, 131 patients died of heart disease. Among men aged 65-plus who had their prostates removed, the five-year incidence of heart disease related death was 5.5 per cent for those receiving ADT, compared with 2 per cent for those not treated with ADT.

For men younger than 65, the incidence of heart disease was 3.6 per cent for those on ADT and 1.2 per cent among those who did not receive ADT.

An increased risk of death was observed in men who received ADT in addition to radiation, but this relationship was not statistically significant.

The researchers suggest that ADT increases the risk of heart disease by increasing BMI, causing fat deposition and decreasing insulin sensitivity.

These conditions lead to metabolic syndrome, which increases the risk of developing coronary artery disease.

Lead researcher Dr Henry Tsai, from Harvard Medical School in Boston, said: 'The results of this study support the view that ADT may contribute to death from cardiovascular causes.

'It highlights the importance of careful cardiovascular evaluation before initiating ADT in patients with prostate cancer.'

However, he added that the study was limited by a short follow-up time with few cardiovascular events observed.

All risk factors for cardiovascular death could not be controlled because the study was based on retrospective analysis.

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