Navigation Links
As FDA Eyes Prostate Cancer Drugs, Experts Urge Caution

Hormonal meds linked to heart risks, but men should not abandon them

TUESDAY, May 4 (HealthDay News) -- When the U.S. Food and Drug Administration announced Monday it was investigating possible links between widely used hormonal prostate cancer drugs and an slight rise in risk for diabetes and heart disease, thousands of men who rely on these drugs to extend their lives were left wondering what to do next.

According to experts, the main advice to those men at the moment is to keep taking the drugs, but use them with caution.

The FDA says it will review a widely used class of prostate cancer drugs called gonadotropin-releasing hormone (GnRH) agonists. These include medications such as Eligard, Lupron, Synarel, Trelstar, Vantas, Viadur, Zoladex and several generic products.

All of these drugs suppress the production of testosterone, a hormone thought to help spur the growth of prostate cancer. Hormone-based therapy is not a cure for prostate cancer, because tumors can eventually become resistant, but it can extend survival.

"Clearly these drugs are needed for the treatment of prostate cancer," stressed prostate cancer expert Dr. Mark Soloway, chair of urology at the University of Miami Miller School of Medicine.

"Lowering the male hormone is by far the most effective treatment," he said, but at the same time, however, "there should be more judgment in prescribing GnRH agonists."

Soloway believes that any increased risk for heart disease and diabetes would be due to a lowering of testosterone. "At this point it makes sense to use hormone therapy when necessary, but not for everyone that has prostate cancer," he said.

Another expert, Dr. Nelson Neal Stone, a clinical professor of urology and radiation oncology at Mount Sinai School of Medicine in New York City, agreed that, "there is evidence that low testosterone can induce metabolic syndrome."

For example, he said, there are studies that have shown that men with advanced prostate cancer who take hormone therapy face a twofold increased risk of developing metabolic syndrome, a cluster of symptoms tied to the development of heart disease.

"When I speak to patients who have to go on these agents, I counsel them about the risks of increased weight gain and I tell them they need to monitor their carbohydrate intake and increase their amount of exercise, and they can decrease the risk of developing metabolic syndrome," he said.

Patients with prostate cancer typically do have some treatment choices. After initial treatment for prostate cancer, whether by surgery or radiation, doctors usually track blood levels of disease-linked prostate-specific antigen (PSA) over time. Based on that, one can initiate hormone therapy, Soloway said, or simply wait and monitor the patient.

"There is further evidence that you should not begin hormone treatment until such time when there is more compelling reason than just a slight rise in PSA," Soloway said. "There are hundreds and hundreds of thousands of such patients."

Soloway believes that many men across the United States are unnecessarily taking hormone therapy for prostate tumors that have not yet spread. "I think hormone therapy can be delayed for months to years in some of these men," he said.

For men with more advanced metastatic prostate cancer, hormone therapy can be used for several months until the PSA goes down, at which point the therapy can be stopped, Soloway said. "If you stop it for the time it takes for the PSA to rise again, that could be many months to a couple or more years," he said.

Men taking hormone therapy need to understand that, as with any drug treatment, there are some risks, Soloway said. But heart disease is largely preventable, and he believes that GnRH agonists might boost heart risks because they cause men to pile on extra pounds.

So, "you want to do what you can to decrease your chance of diabetes, cardiovascular disease. This has to do with diet, keeping your weight down," Soloway said.

For Stone, the toughest part is striking a balance between cancer risk and risks from the number one killer of men, heart disease. "It doesn't make much sense to try and treat their prostate cancer and prevent them from dying from prostate cancer if we are going to increase their risk of them dying from heart disease," he reasoned.

Once patients understand that, Stone hopes they will be motivated to watch their diet and exercise.

In the meantime, men should not stop taking their hormone therapy, but do everything they can to reduce their risk of developing cardiovascular disease and diabetes with lifestyle changes, he said.

"There is always a price you pay for medications," Stone said. "But if we're aware of the consequences of taking the medication, then we can deal with that."

More information

For more information on prostate cancer, visit the American Cancer Society.

SOURCES: Mark Soloway, M.D., professor and chair, urology, University of Miami Miller School of Medicine; Nelson Neal Stone, M.D., clinical professor, urology and radiation oncology, Mount Sinai School of Medicine, New York City

Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Prostate Cancer Diagnosis Raises Suicide Risk
2. Immediate risk of suicide and cardiovascular death after a prostate cancer diagnosis
3. Loss of gene function makes prostate cancer cells more aggressive
4. Experts Issue Warning on Prostate Hormone Therapy
5. Biochemical profile may help diagnose, determine aggressiveness of prostate cancer
6. New Scan May Help Find Aggressive Prostate Tumors
7. Vaccine approach extends life of metastatic prostate cancer patients
8. Prostate Cancer Care Varies By Hospital Type
9. Study confirms prostate cancer is treated differently at county vs. private hospitals
10. Beer Ingredient Eyed in Prostate Cancer Prevention
11. Race, Weight May Influence Success of Prostate Surgery
Post Your Comments:
(Date:11/25/2015)... ... 25, 2015 , ... As part of a global movement ... volunteers together who want to combine talents and resources to help create sustainable ... process. The non-profit launched its first major fundraiser on November 6, 2015 at ...
(Date:11/25/2015)... ... November 25, 2015 , ... TyloHelo ... parts and accessories. , Sauna accessories help improve the bather experience in the ... From basic styles for the purist looking for simplicity in design to accessories ...
(Date:11/25/2015)... ... 2015 , ... For the first time, Vitalalert is donating half of its ... The partnership between the two groups began in 2014 with Vitalalert pledging a portion ... International was founded in 1954 and is an international Christian-based health organization whose mission ...
(Date:11/25/2015)... ... November 25, 2015 , ... On November 25, 2015, officials of Narconon ... announced the release of a new cutting edge recovery program that has been 50 ... with drug- and alcohol-addicted individuals with the purpose to free addicts from the symptoms ...
(Date:11/25/2015)... ... ... Smiles by Stevens is pleased to announce the addition of Botox® for the ... of the benefits of Botox® in the treatment of moderate facial wrinkling, few have ... pain as a result of Jaw Tension, TMJ (temporo-mandibular joint) disorder, and Bruxism (the ...
Breaking Medicine News(10 mins):
(Date:11/26/2015)... Nov. 26, 2015 Research and Markets ... the "2016 Future Horizons and Growth Strategies ... Supplier Shares, Country Segment Forecasts, Competitive Intelligence, Emerging ... --> --> This ... the Japanese therapeutic drug monitoring market, including emerging ...
(Date:11/26/2015)... 26, 2015 ... "2016 Future Horizons and Growth Strategies ... Market: Supplier Shares, Country Segment Forecasts, Competitive ... offering. --> ) has ... Future Horizons and Growth Strategies in the ...
(Date:11/26/2015)... DUBLIN , November 26, 2015 ... has announced the addition of the  ... in the European Therapeutic Drug Monitoring ... Forecasts, Competitive Intelligence, Emerging Opportunities"  report ... ) has announced the addition ...
Breaking Medicine Technology: