Prostate Hormone Therapy May Up Heart Risks

Experts urge more awareness that long-term use has consequences

By Ed Edelson
HealthDay Reporter

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MONDAY, Dec. 7 (HealthDay News) -- Diabetes, heart attacks and other cardiovascular problems appear to be more common in men with prostate cancer who are treated with androgen deprivation therapy, which reduces or eliminates the male sex hormones that can promote cancer growth, a new study has found.

The finding indicates that androgen therapy is overused because its benefits have not been shown to outweigh its dangers in many cases, said Dr. Nancy L. Keating, associate professor of medicine and public health at Harvard Medical School and lead author of a report on the study published online Dec. 7 in the Journal of the National Cancer Institute.

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"There are areas where hormone deprivation therapy has been shown to have a clear benefit," Keating said. "We're not suggesting that men who need hormone deprivation therapy should not have it. But lots of men get the therapy where it has not been shown to have a benefit."

One example is so-called PSA-recurrent cancer. Hormone deprivation therapy is started, Keating said, when levels of cancer-associated prostate-specific antigen (PSA) increase after surgery or radiation therapy, but there are no other indicators of danger.

"There has never been a trial showing an overall benefit in such cases," she said. "When you can have potentially serious adverse effects, you want to show caution."

Similarly, Keating said, no trial has shown an overall benefit for androgen deprivation therapy in cases where "watchful waiting" is chosen rather than radiation therapy or surgery for prostate cancer, Keating said.

"One third of men over 65 who don't have surgery or radiation get this therapy," she said. "Yet its effects have never been studied in a controlled trial."

Previous studies have shown potential dangers related to androgen deprivation therapy in older men, Keating said. The study she led looked at its effects on about 37,000 men treated for prostate cancer at Veterans Affairs hospitals.

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