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As FDA Eyes Prostate Cancer Drugs, Experts Urge Caution
Date:5/4/2010

here 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.

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