Among men with early but high-risk prostate cancer treated with radiation therapy, the addition of hormone therapy may worsen outcomes for the subset of men who have a history of congestive heart failure or heart attack. These results were published in the International Journal of Radiation Oncology\Biology*Physics*.
Treatment options for men with early-stage prostate cancer include surgery, radiation therapy, and active surveillance (close monitoring but no treatment unless the cancer shows signs of worsening).
For certain patients at higher risk of cancer recurrence, radiation therapy may be combined with hormone therapy. The goal of hormone therapy (also known as androgen-deprivation therapy, or ADT) is to slow cancer growth by reducing exposure of the cancer to testosterone. Studies have shown that among men with early-stage, intermediate- or high-risk prostate cancer, the addition of ADT to radiation therapy can improve outcomes. ADT has risks, however, and some men may be particularly susceptible to these adverse effects of treatment.
To explore how a history of heart problems affects outcomes with hormone therapy, researchers conducted a study among 1,378 men with early prostate cancer treated with radiation therapy. All of the men had a history of either congestive heart failure or heart attack. Forty-three percent of the patients received hormone therapy in addition to radiation therapy.
- Among the men with high-risk prostate cancer, five-year risk of death from any cause was 32% among those treated with radiation therapy plus ADT compared with 20% among those treated with radiation therapy alone.
These results suggest that for men with a history of congestive heart failure or heart attack, the addition of ADT to radiation therapy may result in worse survival than radiation therapy alone, even when the cancer is high-risk. This is different than what is seen in men without a history of these heart problems.
Reference: Nguyen PL, Chen M-H, Beckman JA 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. International Journal of Radiation Oncology\Biology*Physics*. Early online publication June 27, 2011.