Hormones Hike Death Risk in Some Prostate Cancers
Patients with congestive heart failure or prior myocardial infarction have increased risk of death
TUESDAY, Aug. 25 (HealthDay News) -- Men with prostate cancer who receive neoadjuvant hormone therapy in combination with radiotherapy face an increased all-cause mortality risk if they have significant cardiovascular comorbidities, including congestive heart failure or prior myocardial infarction, according to a study reported in the Aug. 26 issue of the Journal of the American Medical Association.
Akash Nanda, M.D., of Brigham and Women's Hospital--Dana-Farber Cancer Institute in Boston, and colleagues analyzed outcomes for 5,077 prostate cancer patients treated between 1997 and 2006 with brachytherapy and hormone therapy or only brachytherapy. Hormone therapy consisted of leuprolide or goserelin injections and the non-steroidal antiandrogens bicalutamide or flutamide. The patients were followed until 2008.
The researchers found no association between hormone therapy and all-cause mortality in men without comorbidity (adjusted hazard ratio, 0.97) or in those with a single coronary artery disease risk factor (adjusted hazard ratio, 1.04). However, for men with congestive heart failure related to coronary artery disease or with myocardial infarction, hormone therapy use was associated with an increased risk for all-cause mortality (adjusted hazard ratio, 1.96).
"Given our current findings, future studies assessing the effect of both the duration and extent of hormone therapy on the risk of all-cause mortality in men with known coronary artery disease are needed. In conclusion, this study should heighten awareness about the potential for harm with neoadjuvant hormone therapy use in select men," the authors write.