| Hormone Therapy May Actually Hurt Some Prostate Cancer Patients |
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Hormone Therapy May Actually Hurt Some Prostate Cancer Patients The idea behind hormone therapy for prostate cancer is sound: by starving the tumor of the hormones it needs to grow and spread, you should in theory slow or stop the progression of the disease or even shrink the prostate gland to make other treatments possible. However, men with underlying heart disease may put themselves at higher risk of death by undergoing hormone therapy, according to recently published research. Dr. Akash Nanda, who works with the Harvard Radiation Oncology Program at Brigham & Women's Hospital/Dana-Farber Cancer Institute in Boston, indicates that men who have had a heart attack or heart failure in the past and undergo hormone therapy have a shorter life expectancy than similar patients who do not use the therapy. According to Dr. Ronald Ennis, director of radiation oncology at St. Luke's-Roosevelt Hospital Center, these findings will likely impact the way doctors determine what treatments best suit a particular patient. Standard practice may change quickly as word of the findings hits the medical field. While the study, which was published in August of 2009, needs more research to prove one way or another if there is a true correlation, some physicians are concerned enough to choose alternative treatments for those who have prior heart conditions. Hormone therapy in conjunction with radiation therapy is often used for men who have aggressive prostate cancers, and in these cases the treatment is highly effective, but the risk to patients with underlying health conditions may outweigh that benefit. Doctors have known for a while that long-term use of hormone therapy increased a patient's risk of cardiac disease. They also noticed that the benefit of hormone therapy in prolonging the length of survival for prostate cancer patients was lowered in patients with underlying health conditions. This study made the link between underlying cardiac disease, decreased benefit from therapy and an increased risk of premature death. The study, which lasted five years, took over 5,000 men with an average age of about 70 who had a current diagnosis of localized or locally advanced prostate cancer. The men in the study underwent either radiation therapy or radiation therapy with hormone therapy. The results showed that hormone therapy did not increase the risk of death for men who had no underlying cardiac problems. Men who had had heart attacks or heart failure in the past faced twice as high of a risk of death. These results and results of earlier tests on the benefits of hormone therapy for men with aggressive prostate cancer point to a need for a balanced treatment approach, according to Dr. Nanda. He suggests that men with underlying heart conditions who would stand to benefit from hormone therapy either pursue a different treatment option, or thoroughly treat their cardiac condition prior to undergoing hormone therapy. Men with localized prostate cancer should consider pursuing treatment that does not involve hormone therapy at all if they have preexisting cardiac disease. These options may include HIFU, external beam radiation therapy, watchful waiting or cryotherapy, depending on the size of the prostate gland. |