While hormone therapy is beneficial for many men with prostate cancer, there is growing concern that it may increase heart disease risk factors, according to a report by leading health organizations. The report, written by experts from the American Cancer Society, American Heart Association, and the American Urological Association, summarizes current research on the topic and recommends men discuss the risks and benefits of the treatment with their doctor.

Because the androgens produced by the testicles stimulate prostate cancer growth, doctors sometimes prescribe hormone therapy to block or lower androgen levels. Lowering those levels doesn't cure the cancer, but it can shrink prostate tumors or slow their growth.

Hormone therapy is most often prescribed to men whose prostate cancer has spread to other parts of the body. For some less advanced cancers, it may also be used before or along with other treatments such as surgery or radiation therapy, to try to make these treatments work better. Some doctors may also prescribe hormone therapy for older men or those with serious health problems who have early stage cancers, as an alternative to "active surveillance" or "watchful waiting" (careful follow-up with a doctor).

However, taking these drugs can come with some difficult side effects: low sex drive, impotence, loss of muscle mass, and fatigue, among other things. Hormone therapy (also called androgen deprivation therapy, or ADT) has also been shown to increase body fat, raise low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol), and cause blood sugar abnormalities – all of which can contribute to heart problems.

In this report, experts reviewed current published research on the topic and found that ADT use may increase the risk of heart disease and possibly the risk of cardiac death.

"Based on current data, it was appropriate to conclude that there may be a relationship between ADT therapy in patients with prostate cancer and future cardiovascular risk," said Glenn N. Levine, MD, chair of the advisory writing group and professor of medicine at Baylor College of Medicine in Houston.

More research must be done, the authors concluded. In the meantime, men and the doctors treating them for prostate cancer should discuss the risks and benefits of treatment. Given the possible effects of ADT on heart disease risk factors, men might also want to follow up with their primary care doctor within a few months of starting treatment.

Weighing benefits and risks

If you're a prostate cancer patient considering hormone therapy, talk to your doctor about the benefits and risks of treatment. If you're taking hormone therapy and currently have heart disease risk factors, talk to your doctor about whether taking additional preventative measures, such as adopting a healthier lifestyle and/or or starting on appropriate medications, might be right for you.

The report is published in Circulation: Journal of the American Heart Association as well as the American Cancer Society's peer-reviewed medical journal CA: A Cancer Journal for Clinicians.

For more information, see Prostate Cancer: Hormone (Androgen Deprivation) Therapy.

Reviewed by: Members of the ACS Medical Content Staff

Citation: "Androgen-Deprivation Therapy in Prostate Cancer and Cardiovascular Risk.: Published online February 1, 2010 in CA: A Cancer Journal for Clinicians. First author: Glenn N. Levine, MD, professor of medicine, Baylor College of Medicine in Houston.