Navigation Links
Hormone therapy for prostate cancer patients with heart conditions linked to increased death risk
Date:8/25/2009

Men with coronary artery disease-induced congestive heart failure or heart attack who receive hormone therapy before or along with radiation therapy for treatment of prostate cancer have an associated increased risk of death, according to a study in the August 26 issue of JAMA.

Patients with localized prostate cancer have several options available for treatment, including the use of brachytherapy (treatment in which radioactive seeds are implanted in the prostate), both as monotherapy and in conjunction with external beam radiation therapy, according to background information in the article. Neoadjuvant (treatment that is given before or with the primary treatment) hormonal therapy (HT) is used as a means for prostate gland cytoreduction (decrease in number of cells, as in a tumor) in order to eliminate pubic arch (an arch formed by the pubic bones) interference and improve the ability to perform brachytherapy. Previous research has suggested that "hormonal therapy when added to radiation therapy (RT) for treating unfavorable-risk prostate cancer leads to an increase in survival except possibly in men with moderate to severe comorbidity [co-existing illnesses]. However, it is unknown which comorbid conditions eliminate this survival benefit," the authors write.

Akash Nanda, M.D., Ph.D., of Brigham & Women's HospitalDana-Farber Cancer Institute, Boston, and colleagues assessed whether neoadjuvant HT use in men with prostate cancer treated with brachytherapy affects the risk of all-cause death of men with known coronary artery diseaseinduced conditions, including congestive heart failure and heart attack. The study included 5,077 men (median [midpoint] age, 69.5 years) with localized or locally advanced prostate cancer who were treated with or without a median of 4 months of neoadjuvant HT followed by RT between 1997 and 2006 and were followed up until July 2008.

During the study period, 419 men died. Of those, 200 had no underlying comorbidity, 176 had one coronary artery disease risk factor, and 43 had a history of known coronary artery disease resulting in congestive heart failure or heart attack. Analyses of the data indicated that "when considering comorbidity groups separately, neoadjuvant HT use was not associated with an increased risk of all-cause mortality in men with no comorbidity (9.6 percent vs. 6.7 percent) or a single coronary artery disease risk factor (10.7 percent vs. 7.0 percent) after median follow-ups of 5.0 years and 4.4 years, respectively," the researchers write.

However, for men with coronary artery diseaseinduced congestive heart failure or heart attack, after a median follow-up of 5.1 years, neoadjuvant HT use was associated with nearly twice the risk of all-cause mortality (26.3 percent vs. 11.2 percent).

"It is also important to note that the population of men in whom the use of neoadjuvant HT may be detrimental was limited to 5 percent (256 of 5,077) in this community-based study cohort. This latter point may explain why there has been a survival benefit observed in the major randomized trials comparing HT plus external beam radiation therapy to external beam radiation therapy alone," the authors write.

"The clinical significance of this finding is that for men with favorable-risk prostate cancer and a history of congestive heart failure or myocardial infarction who require neoadjuvant HT solely to eliminate pubic arch interference, alternative strategies such as active surveillance or treatment with external beam radiation therapy or prostatectomy should be considered. However, for men with unfavorablerisk prostate cancer who require HT in addition to radiation therapy to take advantage of its survival benefit, appropriate medical evaluation prior to initiation should facilitate clinicians in balancing the relative risks against the benefits of HT use."


'/>"/>

Contact: Lori J. Shanks
ljshanks@partners.org
617-534-1604
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Hormone Therapy for Early Prostate Cancer Not Always Best
2. Recent Article Reveals Medical Ghostwriting Suppressed Links Between Synthetic Hormones and Breast Cancer
3. Sex Hormone Levels Linked to Fractures in Men
4. In U.S., No Comeback Seen for Hormone Therapy
5. Sex Hormone Protein May Predict Type 2 Diabetes
6. Gut Hormone Could be Key to Blood Sugar
7. New Study Finds Yet Another Link to Cancer, Synthetic Hormones
8. Washington, DC Plastic Surgeon Mark E. Richards, M.D. Says Bio-Identical Hormone Therapy has Staggering Health Benefits that Could Change the Way We Age
9. Hormone Therapy Increases Odds of Ovarian Cancer
10. Asian spice could reduce breast cancer risk in women exposed to hormone replacement therapy
11. JNCI news brief: Breast cancer hormone receptor status and risk of a second primary tumor
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/4/2016)... , ... May 04, 2016 , ... May kicked off ... people across the United States. Dermatologist Dr. Ellen Turner is encouraging her patients, as ... advice and focus on skin safety and health now and in the future. , ...
(Date:5/4/2016)... ... , ... Recognizing that lifestyle medicine is essential to health and healthcare, ... Katz, MD, MPH, president of the American College of Lifestyle Medicine, as their first ... gratifying,” said Katz. “There is so much opportunity to add years to lives, and ...
(Date:5/4/2016)... ... 2016 , ... Bayco Products has announced the introduction of ... in models NSP-9842XL and NSR-9844XL . , First previewed at SHOT Show ... included CR-123 batteries to produce up to 650 lumens in a variety of ...
(Date:5/4/2016)... ... May 03, 2016 – (PRWEB) May 04, 2016 ... products, today revealed the non-toxic benefits of its Tutti Frutti line ... teething pain is just part of the story. These food-grade, silicone ... PVC-, and phthalate-free. , “Many baby toys contain BPA, harmful ...
(Date:5/4/2016)... ... 2016 , ... Fertility Centers of New England announced today the opening of ... Center provides convenient access to care for patients seeking fertility treatment in Maine. “We ... Comprehensive Care in Portland,” said Fertility Centers of New England President and CEO, Joseph ...
Breaking Medicine News(10 mins):
(Date:5/4/2016)... May 4, 2016 Valeritas Holdings, ... an alternative public offering (APO). This was accomplished via ... Valeritas, Inc. and a private placement of approximately 5 ... per share. Under the terms of the ... Valeritas Holdings, Inc. will trade on the OTC Markets ...
(Date:5/4/2016)... 2016 Research and ... Acute lymphocytic Leukemia Market and Competitive Landscape ...      (Logo: http://photos.prnewswire.com/prnh/20160330/349511LOGO ... Market and Competitive Landscape Highlights 2016, provides ... products, Acute Lymphocytic Leukemia epidemiology, Acute Lymphocytic ...
(Date:5/3/2016)... 2016  As a teenager, an active and athletic ... damaged his heart. He continued enjoying sports and recreation ... Shepherd,s heart was giving out and he was a ... 2013, the Mesa, Arizona resident ... a heart transplant, the SynCardia TAH-t is the only ...
Breaking Medicine Technology: