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Among men who have high-risk prostate cancer, the combination of hormone therapy and radiation therapy has been shown to improve overall survival. A new study, however, shows that hormone therapy may increase the risk of death in men with prostate cancer who also have pre-existing heart disease.
The 15-year study (1991-2006) included 14,594 men with prostate cancer who were treated with brachytherapy, a type of radiation therapy in which radioactive material, often called “seeds,” are implanted in the prostate via needles to treat cancer. Brachytherapy is an alternative to traditional external radiation.
A total of 1,378 (9.4%) of the enrolled patients had a history of congestive heart failure or myocardial infarction. Among this group, 22.6% were treated with supplemental external radiation and 42.9% were given hormone therapy for four months.
Of the 1,378 men with a history of heart conditions, the addition of hormone therapy resulted in a significant increase in overall mortality. By five years, 31.8% of the men who underwent hormone therapy had died compared with 19.5% of the men who did not receive hormone therapy.
The study’s lead author, Paul Nguyen, MD, a radiation oncologist at the Dana-Farber/Brigham and Women’s Cancer Center, noted that “for men with localized prostate cancer and a history of heart problems, treatment with hormones plus radiation was associated with a higher all-cause mortality than treatment with radiation alone, even for patients with high-risk malignant disease.”
Read more in our Prostate Cancer Health Center.
Nguyen PL et al. Influence of androgen deprivation therapy on all-cause mortality in men with high-risk prostate cancer and a history of congestive heart failure or myocardial infarction. Intl J Rad Oncol Biol Phys 2011;