Hormones and your heart

Androgen deprivation therapy (ADT) is an important component of many standard strategies for the management of men with prostate cancer. It works by reducing testosterone production (e.g. GnRH agonists, bilateral orchiectomy), which leads to a decrease in the activity of the prostate cancer cells. Men with prostate cancer who undergo long-term ADT are at greater risk of developing dyslipidemia (lipid disorders, e.g. increased total cholesterol, triglycerides and high density lipoprotein [HDL]), insulin resistance, obesity and metabolic syndrome (a combination of conditions that increase the risk of cardiovascular disease and diabetes). There is increasing evidence that the decrease in androgen activity may be associated with a greater likelihood of developing or worsening diabetes and/or heart disease. However, this is still controversial; there is no consistent evidence that there is a higher rate of heart disease-related deaths. For most patients with prostate cancer, ADT will be more beneficial than harmful. In some situations, intermittent therapy (stopping the hormones when PSA levels fall to zero or near zero and starting again once they start to rise) may be appropriate. Certain measures may have potential protective effects, for example: daily aspirin, increased physical activity, weight loss, dietary modifications and/or the addition of a statin medication. These effects will vary from one person to another, and should be discussed with your family physician