Long term follow up indicates that men with comorbidity, predominately a
prior heart attack, who received androgen deprivation therapy (ADT)
died earlier, due to a fatal heart attack.
Androgen deprivation therapy (ADT) and radiation therapy (RT) is known
to prolong survival in men with unfavorable-risk prostate cancer and is
considered a standard of care. However, in 2008, the FDA implemented a
black box warning about ADT use for prostate cancer due to evidence that
suggested an increased risk in non-fatal cardiovascular events. The
association of ADT use and fatal heart attacks has remained uncertain
until now. Specifically, long term follow up of a randomized clinical
trial that compared ADT and radiation therapy (RT) to RT alone finds
that men with significant comorbidity; most commonly prior heart attack,
who received ADT died earlier, due to a fatal heart attack, compared to
men who did not receive ADT.
"These findings give us reason to rethink how we manage prostate
cancer in men with known heart disease," said Anthony D'Amico, MD, lead
author of the research paper and chief of genitourinary radiation
oncology at Brigham and Women's Hospital.. "Specifically, we should be
cautious in prescribing ADT in all men who have had a prior heart
attack. Men with significant heart disease that is not amenable to
medical or surgical correction may be best served with RT alone."
Researchers compared overall survival and death due to prostate
cancer, fatal heart attack and all other causes in a group of 206 men
with unfavorable risk prostate cancer who were randomized to receive RT
alone or RT and six months of ADT. They also categorized the men into
subgroups based on extent of prior comorbidity, including prior heart
attack. After a median follow up exceeding 16 years, researchers found
that overall, survival did not differ between the two groups of men.
When analyzing the subgroups of men by differing extent of comorbidity,
researchers found that among men whose comorbidity included prior heart attack,
treatment with RT and ADT shortened survival due to higher rates of
fatal heart attacks, while prolonging survival in men with no or minimal
comorbidity.
This site is for information on the various Chemo treatments and Stem Cell Therapies since 1992. This journey became bitter sweet in 2014, with the passing of my beautiful and dear wife. Sherry, had fought Non - Hodgkins Lymphoma(NHL) since 1990, in and out of remissions time and time again. From T-Cell therapies(1990's) to Dual Cord Blood Transplant(2014), she was in Clinical Trials over the years. This site is for informational purpose only and is not to promote the use of certain therapies.
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