Androgen-deprivation therapy, which is a common treatment for prostate cancer, has been tentatively linked with an increased risk of cardiovascular disease. A new study solidifies these concerns. Share on Pinterest A common prostate cancer treatment comes under scrutiny in a new study. Prostate cancer needs testosterone to grow and thrive, so androgen-deprivation therapy (ADT) is designed to reduce the amount of testosterone in the body to close to zero, thereby helping to slow cancer’s growth. Although the findings are controversial, some studies have shown that ADT combined with radiation therapy is more successful at treating prostate cancer than just radiation alone. Currently, ADT is recommended for advanced prostate cancer. But it is increasingly being used to treat localized prostate cancer, despite minimal evidence for its efficacy. At the same time, the number of localized prostate cancer cases has increased dramatically over recent years, due in part to the more widespread use of prostate-specific antigen (PSA) testing. Side effects of ADT — including erectile dysfunction, diabetes, bone loss, and swollen breast tissue, or gynecomastia — can be fairly substantial. Added to this, there is growing evidence to suggest that low testosterone levels might increase the risk of cardiovascular disease (CVD).

Studies looking for links between CVD and ADT have reached conflicting conclusions. For instance, one meta-analysis found a 40 percent increased risk of non-fatal CVD in men with prostate cancer who had received ADT. On the other hand, an earlier study found no link at all between ADT and cardiovascular mortality. It has therefore been difficult for researchers, so far, to draw accurate lines between heart health and ADT. Studies have run into a range of problems: some primarily looked at older men, wherein heart conditions would already be more common, and some did not take information about the other medications that participants were taking. And, even when links have been found, it is difficult to know whether ADT caused the CVD or simply worsened a pre-existing heart condition. A new study set out to rectify the issues experienced in previous studies. Led by Reina Haque, Ph.D., of Kaiser Permanente Southern California in Pasadena, their findings are published this month in the British Journal of Cancer. The authors write, “[O]ur goal was to assess the association of ADT and important incident CVD outcomes in a cohort that also included younger men.” “We accounted,” they add, “for important confounders, including prior CVD history, PSA levels, CVD medications, and CVD risk factors. Additionally, we assessed whether ADT only has effect on new-onset CVD or also on the progression of pre-existing cardiovascular conditions.”