Alphabetical list:
A B C D E F G H I J K L M N O P R S T U V W X Y Q Z 1 2 3 4 5 6 7 8 9
News: December 6, 2009
Prostate Hormone Therapy May Up Heart Risks
December 6, 2009Diabetes, heart attacks and other cardiovascular problems appear to be more common in men with prostate cancer who are treated with androgen deprivation therapy, which reduces or eliminates the male sex hormones that can promote cancer growth, a new study has found.
The finding indicates that androgen therapy is overused because its benefits have not been shown to outweigh its dangers in many cases, said Dr. Nancy L. Keating, associate professor of medicine and public health at Harvard Medical School and lead author of a report on the study published online Dec. 7 in the Journal of the National Cancer Institute.
"There are areas where hormone deprivation therapy has been shown to have a clear benefit," Keating said. "We're not suggesting that men who need hormone deprivation therapy should not have it. But lots of men get the therapy where it has not been shown to have a benefit."
One example is so-called PSA-recurrent cancer. Hormone deprivation therapy is started, Keating said, when levels of cancer-associated prostate-specific antigen (PSA) increase after surgery or radiation therapy, but there are no other indicators of danger.
"There has never been a trial showing an overall benefit in such cases," she said. "When you can have potentially serious adverse effects, you want to show caution."
Similarly, Keating said, no trial has shown an overall benefit for androgen deprivation therapy in cases where "watchful waiting" is chosen rather than radiation therapy or surgery for prostate cancer, Keating said.
"One third of men over 65 who don't have surgery or radiation get this therapy," she said. "Yet its effects have never been studied in a controlled trial."
Previous studies have shown potential dangers related to androgen deprivation therapy in older men, Keating said. The study she led looked at its effects on about 37,000 men treated for prostate cancer at Veterans Affairs hospitals.
Surgical removal of the testes was associated with a 40 percent increased risk for heart disease and a more than doubled risk for heart attack. Use of multiple hormone-blocking agents was associated with a 27 percent increased risk for heart disease.
The greatest risk was found for drugs that target gonadotropin-releasing hormone: 159.4 cases of diabetes per 1,000 person-years, compared with 87.5 for men who did not have androgen deprivation therapy, as well as a 35 percent increased risk for sudden cardiac death, a comparable increase in heart attack risk and a 22 percent increased risk for stroke.
Observational studies, which include all people with a condition, can never conclusively prove cause and effect, Keating acknowledged, because "the thing we can't account for is whether people who are on a treatment are different from those who aren't." But detailed evidence about the potential dangers of androgen deprivation therapy has not emerged from the more rigorous controlled trials that have been done "because they have looked only at cardiovascular deaths, and most patients who have heart attacks do not die of those heart attacks," she said.
Dr. Peter Albertsen, a professor and chief of urology at the University of Connecticut Health Center, said that "the point of this paper is to help physicians understand that long-term use of this therapy carries consequences." Albertsen wrote an accompanying editorial in the journal.
Anti-hormone therapy was developed to treat the pain and other problems of advanced prostate cancer, Albertsen said, and so it was generally used for only three to five years.
"Now, many more men are being started on androgen deprivation therapy long before there are any symptoms of prostate cancer so they may be on it for up to 15 years," he said. "We are beginning to realize that there can be significant problems in terms of cardiovascular risk. So the lesson is that if you start the therapy early, you should be sure that there is increased survival because there is a downside."
Dr. Eric A. Klein, chairman of the Cleveland Clinic Glickman Urological and Kidney Institute, said that the study "is confirmatory of a lot of other, smaller studies.
"There is a growing realization that we cannot use androgen deprivation therapy in a haphazard fashion," Klein said. "It does save lives or delay progression for men with metastatic prostate cancer so the trade-offs there are reasonable. But in many other cases, the downside probably exceeds the benefit."
Archive issues: (50)
Archive list: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 [16] 17
October 17, 2011 | Sen. Grassley Seeks FDA Scrutiny of Paxil and Suicide RiskWASHINGTON, June 12, 2008 Senator Chuck Grassley has asked the Food and Drug Administration to carefully scrutinize information it received from drug maker GlaxoSmithKline about the anxiety disorder drug Paxil, based on the contents of a newly ...
September 21, 2009 | Topical cream studied for erectile dysfunctionScientists from Albert Einstein College of Medicine of Yeshiva University are working on a cream to rub on and treat erectile dysfunction (ED). The cream could prove to be safer than oral medications used to deliver nitric oxide to the cells that improves blood flow to treat impotency. Using encapsulated ...
May 21, 2012 | Onyx Rises on Analyst View of Blood Cancer DrugNEW YORK -- Onyx Pharmaceuticals Inc. shares rose Thursday after a Bernstein Research analyst started covering the stock with an "Outperform" rating, saying he thinks the company’s blood cancer drug candidate will reach $1 billion in annual sales by 2016. THE SPARK: Analyst Geoffrey Porges said he thinks that the drug, Kyprolis, will win broad marketing approval from regulators in 2014. He said sales could reach $2 billion annually by ...
Related articles:
Chronic prostatitis/chronic pelvic pain syndrome - treatment
No treatment required. It is standard practice for men with infertility and category IV prostatitis to be given a trial of antibiotics and/or anti-inflammatories however evidence for efficacy are weak. Since signs of asymptomatic prostatic inflammation may sometimes be associated with prostate cancer, this can be addressed by tests that assess the ratio of free-to-total PSA. The results of these tests were significantly different in prostate cancer and category IV ...Section: Prostatitis
Risk-taking
Men, significantly more so than women, tend to drink and drive, not to wear a seat belt, to be aggressive and fight, to drive fast and dangerously. Men are also more likely to be involved in a homicide, to be involved in a motor vehicle accident and other accidents. Men are in fact three times more likely to die of accidents than females. Men make up ...Section: Mens health risks
Treatment - diet
The foundation of therapy is a modification of diet to help patients avoid those foods which can further irritate the damaged bladder wall. Common offenders are highly spiced or acidic foods and include alcohol, coffees, teas, herbal teas, green teas, all sodas (particularly diet), concentrated fruit juices, tomatoes, citrus fruit, cranberries, the B ...Section: Interstitial cystitis