THE "NEW" PROSTATE CANCER INFOLINK

The American Heart Association, the American Cancer Society, and the American Urology Association have come together to issue a joint “science advisory” on androgen deprivation therapy (ADT) and cardiovascular risk. The document has also been endorsed by the American Society for Radiation Oncology.

The entire document is available on line, on the web sites of the various organizations. The “New” Prostate Cancer InfoLink recommends this science advisory as a resource document for prostate cancer support group leaders and other prostate cancer educators.

We can summarize the key findings of this science advisory as follows:

• ADT can adversely affect traditional cardiovascular risk factors, including serum lipoprotein levels, insulin sensitivity, and obesity.
• Recent studies have reported a relationship  between ADT and an increased risk for cardiovascular disease in patients with prostate cancer.
• At this time, there are no definitive data on whether ADT is associated with an increased risk of cardiovascular death.
• There may be a real relationship between ADT and cardiovascular risk in at least some men with prostate cancer.
• At this time, patients for whom ADT is believed to be beneficial should be treated by their normal clinician and do not need referral to internists, endocrinologists, or cardiologists for evaluation before initiation of ADT.
• Also, at this time, there is no role for specific cardiac testing or coronary intervention in patients with cardiovascular disease before initiation of ADT.
• Physicians treating patients for prostate cancer should carefully weigh the potential benefits of initiating ADT against any possible risks in each individual patient.
• Patients being treated with ADT for prostate cancer should be referred to their primary care physician for periodic follow-up, because of the metabolic effects of androgen deprivation.

In addition, the science advisory points out that all patients with a history of heart disease should always receive secondary preventive measures as recommended by the American Heart Association and other expert organizations, including, when appropriate, lipid-lowering therapy, antihypertensive therapy, glucose-lowering therapy, and antiplatelet therapy.

Filed under: Living with Prostate Cancer, Management, Treatment Tagged: | ADT, androgen deprivation therapy, cardiovascular, risk, science advisory