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Hormone therapy ups death risk for prostate cancer patients with heart disease.

Byline: ANI

Washington, Aug 26 (ANI): Prostate cancer prostate cancer, cancer originating in the prostate gland. Prostate cancer is the leading malignancy in men in the United States and is second only to lung cancer as a cause of cancer death in men.  patients, who also suffer from heart conditions, have increased death risk if they undergo hormone therapy Hormone therapy
Treating cancers by changing the hormone balance of the body, instead of by using cell-killing drugs.

Mentioned in: Breast Cancer, Thyroid Cancer

hormone therapy 
, revealed a study led by an Indian-origin scientist.

Dr. Akash Nanda, from Boston, has found that when men with coronary artery coronary artery
1. An artery with origin in the right aortic sinus; with distribution to the right side of the heart in the coronary sulcus, and with branches to the right atrium and ventricle, including the atrioventricular branches and
 disease-induced congestive heart failure congestive heart failure, inability of the heart to expel sufficient blood to keep pace with the metabolic demands of the body. In the healthy individual the heart can tolerate large increases of workload for a considerable length of time.  or heart attack receive hormone therapy before or along with radiation therapy for treatment of prostate cancer, they have an associated increased risk of death.

His study report says that patients with localized prostate cancer have several options available for treatment, including the use of brachytherapy (treatment in which radioactive seeds are implanted in the prostate), both as monotherapy and in conjunction with external beam radiation therapy.

Neoadjuvant (treatment that is given before or with the primary treatment) hormonal therapy Hormonal therapy
Use of hormone medications to inhibit menstruation and relieve the symptoms of endometriosis.

Mentioned in: Endometriosis
 (HT) is used as a means for prostate gland cytoreduction (decrease in number of cells, as in a tumor) in order to eliminate pubic arch (an arch formed by the pubic bones) interference and improve the ability to perform brachytherapy.

Previous research has suggested that "hormonal therapy, when added to radiation therapy (RT) for treating unfavorable-risk prostate cancer, leads to an increase in survival except possibly in men with moderate to severe comorbidity [co-existing illnesses]. However, it is unknown which comorbid conditions eliminate this survival benefit," the authors write.

Dr. Nanda his colleagues assessed whether neoadjuvant HT use in men with prostate cancer treated with brachytherapy affects the risk of all-cause death of men with known coronary artery disease-induced conditions, including congestive heart failure and heart attack.

The researchers conducted the study on 5,077 men (median [midpoint mid¬∑point ¬†
1. Mathematics The point of a line segment or curvilinear arc that divides it into two parts of the same length.

2. A position midway between two extremes.
] age, 69.5 years) with localized or locally advanced prostate cancer who were treated with or without a median of 4 months of neoadjuvant HT followed by RT between 1997 and 2006 and were followed up until July 2008.

They found that during the study period, 419 men died, out of which, 200 had no underlying comorbidity, 176 had one coronary artery disease coronary artery disease, condition that results when the coronary arteries are narrowed or occluded, most commonly by atherosclerotic deposits of fibrous and fatty tissue.  risk factor, and 43 had a history of known coronary artery disease resulting in congestive heart failure or heart attack.

The researchers said that the analyses of the data indicated that "when considering comorbidity groups separately, neoadjuvant HT use was not associated with an increased risk of all-cause mortality in men with no comorbidity or a single coronary artery disease risk factor after median follow-ups of 5.0 years and 4.4 years, respectively."

But, for men with coronary artery disease-induced congestive heart failure or heart attack, after a median follow-up of 5.1 years, neoadjuvant HT use was associated with nearly twice the risk of all-cause mortality.

"The clinical significance of this finding is that for men with favorable-risk prostate cancer and a history of congestive heart failure or myocardial infarction who require neoadjuvant HT solely to eliminate pubic arch interference, alternative strategies such as active surveillance or treatment with external beam radiation therapy or prostatectomy Prostatectomy Definition

Prostatectomy refers to the surgical removal of part of the prostate gland (transurethral resection, a procedure performed to relieve urinary symptoms caused by benign enlargement), or all of the prostate (radical prostatectomy,
 should be considered.

"However, for men with unfavourable-risk prostate cancer who require HT in addition to radiation therapy to take advantage of its survival benefit, appropriate medical evaluation prior to initiation should facilitate clinicians in balancing the relative risks against the benefits of HT use," said the researchers

The study has been published in the latest issue of JAMA JAMA
Journal of the American Medical Association
. (ANI)

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Publication:Asian News International
Date:Aug 26, 2009
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