Alarge prospective study found that men without
preexisting cardiovascular disease had a significantly
higher risk of heart failure after having androgen
deprivation therapy (ADT) to treat localized prostate cancer.
The study included 7,637 men with prostate cancer,
30% of whom had ADT. All the men initially underwent
ADT was associated with an 81% increased risk of
heart failure in men who did not have preexisting
cardiovascular disease. For men with preexisting
cardiovascular disease, ADT was associated with 44%
elevated risk of arrhythmia and a three-fold higher risk of
developing a conduction disorder.
As with prospective studies, the data shows a
correlation, not a cause-and-effect relationship. “This study
provides the basis for identifying high-risk men treated
with ADT who might benefit from regular cardiac
monitoring and lifestyle modification recommendations,”
the study authors wrote.
Androgen-deprivation therapy (ADT) is also called
hormonal therapy. It can be used in men who have
prostate cancer that has spread too far to be cured
by surgery or radiation, or if cancer comes back.
Large Analysis Finds No Link
Between Alzheimer’s or
Dementia Risks and ADT
An analysis of more than 1.2 million men with prostate
cancer found no increased risk for Alzheimer’s disease in
men treated with androgen-deprivation therapy (ADT).
The men in the study were Medicare patients aged 67 years
or older who had advanced prostate cancer. Investigators
examined 14 years of claims data. Of the 1.2 million men in
the study, 35% were treated with ADT (chemical or surgical).
Almost 9% of the men developed Alzheimer’s and 18.8%
developed dementia. Another 26-33% of the men died without
having Alzheimer’s or dementia.
In adjusted risk model analyses, there was actually a 2%
decrease in the rate of Alzheimer’s in men who had ADT,
possibly attributed to the high death rate in the study subjects.
There was also a 1% decreased risk of dementia, which the
authors said was not clinically important.
Other studies have found conflicting results regarding an
increased risk of dementia, Alzheimer’s and other cognitive
impairments in patients who undergo ADT, including a metaanalysis
by Nead et al. in 2017 that showed the risk for dementia
was 47% higher after ADT when compared to a lesser-exposed
group of men. The authors of the new study suggested that the
different findings could come from using different methods and
source data. Future research will continue to search for clarity on
the possible link so clinicians can advise patients about the
potential risks of ADT.