A recently published article has revealed the very  important fact that the use of hormonal treatment for early prostate cancer increases the risk of heart disease. The risk is maximum with GnRH agonists or orchiectomy and least with antiandrogens. This finding is very important since patients with early disease  otherwise have  good overall survival.

Details

A Swedish study presented in an international conference on September 22^nd 2009 revealed some important facts regarding prostate cancer and hormonal therapy. The risk of heart disease is increased by all hormonal therapies but the maximum increase is by GnRH agonists. It is important to consider heart disease prior to starting any hormonal therapy, especially as these drugs are prescribed not only for metastatic prostate cancer but also for less severe disease. This was the largest study to date focusing on the primary treatment. Compared to the general population, men taking hormonal therapy for prostate cancer showed substantial increase in the risk for developing cardiovascular disease that required any kind of hospitalization, and of dying from this. Some important points are:-

1. The risk  for a nonfatal Myocardial infarction was increased by 24% and for fatal Myocardial infarction by 28%.
2. The risk  for developing cardiac arrhythmias was increased by 19% and  for dying from this by 5%.
3. The risk for developing ischemic heart disease was increased by 31% and  for dying from this by 21%.
4. The risk  for heart failure was increased by 26% (for both incidence and mortality).

Patients who were on GnRH agonists or who underwent orchiectomy were at the highest risk, and those who were taking antiandrogen were at the lowest risk, although the risk in the latter was still elevated.

The main message from this study for doctors who prescribe  hormonal therapy,  is to be aware of the fact that this kind of medication has an adverse effect on the cardiac profile of  patients.