Some Prostate Cancer Patients May Not Benefit From Hormone Therapy
By Steven Reinberg
HealthDay Reporter
TUESDAY, Sept. 22, 2015 (HealthDay News) -- Men with prostate cancer who also have had a heart attack may fare better with radiation therapy alone rather than with the standard treatment of radiation plus hormone therapy, a new analysis suggests.
Over an average of 17 years of follow-up, men with high-risk prostate cancer who also had a heart condition lived longer after radiation treatment alone than similar men who had radiation and hormone therapy. Men who didn't have heart problems lived longer if they had both treatments, the researchers added.
"There have been several trials looking at radiation with or without hormone therapy in high-risk prostate cancer which found a survival benefit from combined treatment," said lead researcher Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston.
However, whether hormone therapy causes an increase in death from heart problems has been controversial, he said. Several studies have not found a difference in survival.
D'Amico and his colleagues looked specifically at men who had other medical problems in addition to high-risk prostate cancer -- particularly at men who had suffered a heart attack.
High-risk prostate cancer is cancer that is confined to the prostate but likely to spread to other parts of the body.
"We found that there was no survival benefit to adding hormones to men who had had a heart attack," D'Amico said. "In fact, they died sooner."
The main cause of death was a fatal heart attack, he said.
"We know hormone therapy causes a variety of problems, including raised blood pressure and raised blood sugar," D'Amico explained.
Because this study analyzed data from a completed trial, D'Amico said it doesn't prove hormone therapy caused heart attacks. "It's an association, it's not proof," he said. "But there is a good likelihood that it's true," he added.
D'Amico suggested that men who have had a heart attack but need hormone therapy should get their cardiologist involved to make sure their heart disease is controlled.
"We don't withhold hormone therapy in men with heart disease, but we do want a cardiologist to make sure everything is managed," D'Amico said.
HealthDay Reporter
TUESDAY, Sept. 22, 2015 (HealthDay News) -- Men with prostate cancer who also have had a heart attack may fare better with radiation therapy alone rather than with the standard treatment of radiation plus hormone therapy, a new analysis suggests.
Over an average of 17 years of follow-up, men with high-risk prostate cancer who also had a heart condition lived longer after radiation treatment alone than similar men who had radiation and hormone therapy. Men who didn't have heart problems lived longer if they had both treatments, the researchers added.
"There have been several trials looking at radiation with or without hormone therapy in high-risk prostate cancer which found a survival benefit from combined treatment," said lead researcher Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston.
However, whether hormone therapy causes an increase in death from heart problems has been controversial, he said. Several studies have not found a difference in survival.
D'Amico and his colleagues looked specifically at men who had other medical problems in addition to high-risk prostate cancer -- particularly at men who had suffered a heart attack.
High-risk prostate cancer is cancer that is confined to the prostate but likely to spread to other parts of the body.
"We found that there was no survival benefit to adding hormones to men who had had a heart attack," D'Amico said. "In fact, they died sooner."
The main cause of death was a fatal heart attack, he said.
"We know hormone therapy causes a variety of problems, including raised blood pressure and raised blood sugar," D'Amico explained.
Because this study analyzed data from a completed trial, D'Amico said it doesn't prove hormone therapy caused heart attacks. "It's an association, it's not proof," he said. "But there is a good likelihood that it's true," he added.
D'Amico suggested that men who have had a heart attack but need hormone therapy should get their cardiologist involved to make sure their heart disease is controlled.
"We don't withhold hormone therapy in men with heart disease, but we do want a cardiologist to make sure everything is managed," D'Amico said.
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