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:6/26/2016)... Aliso Viejo, California (PRWEB) , ... June 26, 2016 , ... ... for Final Cut Pro X. , "Film editors can give their videos a whole ... artistically," said Christina Austin - CEO of Pixel Film Studios. , ProSlice Levels ...
(Date:6/26/2016)... ... ... Kasmer, a legally blind and certified personal trainer is helping to develop a weight loss ... plans to fix the two major problems leading the fitness industry today:, ... , They don’t eliminate all the reasons people quit their exercise program ...
(Date:6/25/2016)... Washington, D.C. (PRWEB) , ... June 25, 2016 ... ... will discuss health policy issues and applications at AcademyHealth’s Annual Research Meeting June ... share their work on several important health care topics including advance care planning, ...
(Date:6/25/2016)... ... , ... The temporary closing of Bruton Memorial Library on June 21 due to a possible ... often overlooked aspect of head lice: the parasite’s ability to live away from a human ... but a necessary one in the event that lice have simply gotten out of control. ...
(Date:6/25/2016)... ... June 25, 2016 , ... First Choice Emergency Room , the largest ... as the Medical Director of its new Mesquite-Samuell Farm facility. , “We are ... Mesquite location,” said Dr. James M. Muzzarelli, Executive Medical Director of First Choice Emergency ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 Research ... "Pharmaceutical Excipients Market by Type (Organic Chemical (Sugar, Petrochemical, ... (Oral, Topical, Coating, Parenteral) - Global Forecast to 2021" ... The global pharmaceutical excipients market is ... a CAGR of 6.1% in the forecast period 2016 ...
(Date:6/23/2016)... , June 23, 2016 ... CAPR ), a biotechnology company focused on the ... announced that patient enrollment in its ongoing randomized ... has exceeded 50% of its 24-patient target. Capricor ... the third quarter of 2016, and to report ...
(Date:6/23/2016)... INDIANAPOLIS , June 23, 2016 ... Tomorrow,s Leaders Scholarship is any indication, the future is ... online at www.diabetesscholars.org by the Diabetes Scholars ... in the way of academic and community service excellence. ... program since 2012, and continues to advocate for people ...
Breaking Medicine Technology: