A type of cancer that’s monopolized by men, prostate cancer might even go unnoticed in some individuals who die due to other causes such as heart attack or stroke. Prostate is a walnut-shaped gland found only in men that makes fluid that’s part of the semen. Situated below the bladder in front of the rectum, the size of the gland changes with age becoming larger as a person grows old. Prostate cancer, one of the most common forms of cancer in men, is one that occurs in the prostate gland. The cancer normally spreads very slowly and in some cases might need minimum or no treatment at all but other times certain types of the cancer are more aggressive and can spread quickly. While going in for radiation and chemotherapy immediately is not required in the case of all men diagnosed with prostate cancer there are multiple factors to consider such as age, health and side effects of the treatment such as incontinence and erectile dysfunction before choosing any treatment.
Treating Prostate Cancer
Mostly men choose testosterone-blocking drugs as a common treatment option and this so-called androgen deprivation therapy (ADT) has been linked with an increase in cardiovascular disease in men. Prostate cancer needs the presence of testosterone to grow and survive and with the help of ADT it is possible to bring down testosterone levels close to zero in the human body thereby preventing the survival of the cancer. Though ADT is usually recommended for treating patients with advance-stage prostate cancer there are many cases of ADT being used to treat localized prostate cancer too. ADT is usually used alongside radiation therapy in those men whose prostate cancer risks are too high without which their survival rates are also affected. ADT is often rejected unless and until the patient desperately requires the treatment procedure as it has the potential to cause harmful side effects such as erectile dysfunction, bone loss, diabetes and swollen breast tissue. While these are bad there is no harm to the life of the surviving person but now, we have data showing that reduced testosterone levels can increase the risk of cardiovascular disease (CVD) which is highly disturbing! But we have had conflicting results until now as there are studies that show/don’t show a link between ADT and CVD risk.
A study published in the journal British Journal of Cancer included more than 7000 men who were diagnosed with localized prostate cancer of which a third of them received ADT treatment. After a follow-up of 13 long years men who were given ADT and without any heart disease saw an 81% increase in their risk of heart failure. Men who already had CVD witnessed a 44% increase in the risk of arrhythmia. Learn more about arrhythmia and how its risk can be minimized with effective lifestyle changes by visiting the website www.firsteatright.com. Researchers found that decreased testosterone levels had a greater impact in increasing the risk of CVD in more than one way-fat mass increased which is a huge risk factor for CVD, there are higher chances of abnormal lipid profiles, pro-inflammatory chances and hypertension, all of which increase the risk of CVD.
If you are one of those men who already had a heart attack and planning to undergo ADT plus radiation treatment for prostate cancer you are digging your own grave as the chances of a heart attack is overboard and its effect are close to fatal. A group of 206 men with unfavorable-risk prostate cancer received treatment in the form of radiation alone or radiation and six months of ADT. These men were categorized into various subgroups based on their health conditions such as heart disease. After a follow-up of 16 years researchers found that in the subgroup that had a previous heart attack administering these individuals with ADT plus radiation reduced their 15-year survival rate to 8% compared to 20% for those who were treated with radiation alone.
If these are not more than enough reasons to skip ADT plus radiation as the treatment protocol for prostate cancer, a study published recently in the American Heart Association’s journal Circulation shows how the testosterone-lowering drugs affect the heart’s QT interval-the time taken by the ventricles of the heart to contract and relax (QT interval is long when heart rate is slow and short when heart rate is fast). Longer a QT interval greater are the risks for the individual to develop serious heart rhythm problems and also a condition called torsade de pointes that can lead to sudden death. When a group of researchers sorted through a global health database looking for any link between men with long QT, torsade de pointes or sudden death with testosterone-blocking therapy they found that 7 of the 10 drugs were indeed linked to such disastrous effects. They came to the conclusion that when any patient is prescribed with antiandrogen drugs it is the responsibility of the physician to monitor for torsade de pointes and also monitor for other risk factors as well.
Before suggesting any treatment procedure relating to testosterone blockage the physician must inform the patient of the potential side effects such as heart failure risk and also help them with providing cardiovascular examination once the patient chooses to go with ADT.
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Dietitian & Nutritionist Dr. Nafeesa Imteyaz.