Influence of Androgen Suppression Therapy for Prostate Cancer on the Frequency and Timing of Fatal Myocardial Infarctions

D’Amico, Anthony V.; Denham, James W.; Crook, Juanita; Chen, Ming‐Hui; Goldhaber, Samuel Z.; Lamb, David; Joseph, David; Tai, Keen‐Hun; Malone, Shawn; Ludgate, Charles; Steigler, Allison; Kantoff, Philip W.

doi:10.1200/jco.2006.09.3369

Cited by 472 publications

(317 citation statements)

References 26 publications

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“…Several other side effects of castration, including hot flushes, anaemia, and metabolic syndrome, are also increasingly recognised, although others such as cognitive dysfunction require further research to clarify their impact (Sharifi et al, 2005). It has recently been suggested that the use of ADT is associated with earlier onset of fatal myocardial infarction in men aged 65 years or above (D'Amico et al, 2007) and that in patients with locoregional prostate cancer it may be associated with an increase risk of cardiovascular disease not seen with orchidectomy (Keating et al, 2006). An alternative approach is to evaluate agents that are potentially as effective as, or more effective than, LHRH analogues in activity, for example, by achieving castrate levels of testosterone while avoiding some of the side effects of the castration syndrome.…”

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confidence: 99%

Parenteral oestrogen in the treatment of prostate cancer: a systematic review

et al. 2008

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The objectives of this study were to assess the effectiveness and safety of parenteral oestrogen in the treatment of prostate cancer, and to examine any dose relationship. A systematic review was undertaken. Electronic databases, published paper and internet resources were searched to locate published and unpublished studies with no restriction by language or publication date. Studies included were randomised controlled trials of parenteral oestrogen in patients with prostate cancer; other study designs were also included to examine dose -response. Study selection, appraisal, data extraction and quality assessment were performed by one reviewer and independently checked by another. Twenty trials were included in the review. The trials differed with regard to the included patients, formulation and dose of parenteral oestrogen, comparator used, outcome measures reported and the duration of follow-up. The results provide no evidence to suggest that parenteral oestrogen, in doses sufficient to produce castrate levels of testosterone, is less effective than luteinising hormone-releasing hormone (LHRH) or orchidectomy in controlling prostate cancer, or that it is consistently associated with an increase in cardiovascular mortality. Further well-conducted trials of parenteral oestrogen are required. A pilot randomised controlled trial comparing transdermal oestrogen to LHRH analogues in men with locally advanced or metastatic prostate cancer is underway in the United Kingdom.

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confidence: 99%

Parenteral oestrogen in the treatment of prostate cancer: a systematic review

et al. 2008

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“…[6][7][8] Furthermore, recent data have linked ADT to an increased risk of cardiovascular morbidity and mortality, including new onset diabetes, coronary artery disease and sudden cardiac death. [9][10][11][12] When ADT fails, patients with hormone-refractory PC have fewer treatment options and a poorer prognosis as the mainstay of therapy is cytotoxic chemotherapy that confers a mere 2-month survival advantage. 13 In recent years, increased attention has focused on exercise as a supportive adjunct therapy following a cancer diagnosis.…”

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confidence: 99%

Exercise therapy across the prostate cancer continuum

Antonelli

Freedland

Jones

2009

Prostate Cancer Prostatic Dis

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Exercise has been increasingly investigated as an adjunct therapy for cancer patients. The purpose of this paper is to comprehensively review the literature regarding exercise as a therapeutic adjunct for prostate cancer (PC). Several studies in patients with PC have shown quality of life improvements associated with exercise. Although no study has established the effect of exercise as a monotherapy for PC, the molecular mechanisms responsible for the potential association between exercise and PC are being elucidated. Given the low-risk, high-reward nature of these studies, further investigations are needed to better define the function of exercise along the PC continuum.

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“…Greater risk of cardiovascular death was observed only in the subset of men who underwent radical prostatectomy. A pooled analysis of three small randomized controlled trials of radiation therapy with or without ADT for intermediate and high-risk prostate cancer reported that ADT was associated with shorter time to fatal myocardial infarction [8]. Notably, the analyses included only 51 primary events and the association was observed only in a subset of older men.…”

Section: Do Gnrh Agonists Increase Cardiovascular Mortality?mentioning

confidence: 99%

Androgen deprivation therapy and risk for diabetes and cardiovascular disease in prostate cancer survivors

Smith

2008

Curr Urol Rep

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Gonadotropin-releasing hormone (GnRH) agonists are the mainstay of treatment for recurrent and metastatic prostate cancer. GnRH agonists are also an important part of therapy for many men with localized or locally advanced prostate cancer. Although GnRH agonists improve survival in certain settings, they involve adverse effects including vasomotor flushing, obesity, and osteoporosis. This article describes the evidence that GnRH agonists increase risk for diabetes and cardiovascular disease and reviews the potential mechanisms for treatment-related morbidity.

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Influence of Androgen Suppression Therapy for Prostate Cancer on the Frequency and Timing of Fatal Myocardial Infarctions

Abstract: The use of AST is associated with earlier onset of fatal MIs in men age 65 years or older who are treated for 6 months compared with men who are not treated with AST.

Cited by 472 publications

References 26 publications

Parenteral oestrogen in the treatment of prostate cancer: a systematic review

Parenteral oestrogen in the treatment of prostate cancer: a systematic review

Exercise therapy across the prostate cancer continuum

Androgen deprivation therapy and risk for diabetes and cardiovascular disease in prostate cancer survivors

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