Metabolic syndrome increases disease progression in advanced prostate cancer

This study investigated the impact of metabolic syndrome on treatment outcome with abiraterone acetate (Zytiga) for hormone-resistant prostate cancer.

Researchers concluded that metabolic syndrome has an adverse outcome on disease progression in advanced prostate cancer.

Hormone therapy is a common treatment used in prostate cancer. By reducing the levels of male sex hormones active in prostate cancer (such as testosterone), cancer progression can be delayed and survival increased. In some patients, hormone therapy can cause side effects such as high blood pressure, weight gain, high glucose and high cholesterol levels (collectively known as metabolic syndrome). Other patients may become resistant (no longer respond) to hormone therapy over time, and abiraterone acetate is often recommended as an alternative hormone treatment.

The presence of metabolic syndrome is associated with poorer cancer treatment outcome. Addressing metabolic syndrome early could, therefore, improve survival. However, the effect of metabolic syndrome in patients that have become resistant to hormone therapy has not been fully studied. 

This study included 178 men with advanced hormone-resistant prostate cancer. Of these, 67 were found to have metabolic syndrome. Treatment outcome with abiraterone acetate was compared between men with metabolic syndrome and men without metabolic syndrome. Over the course of treatment, 13 additional men (12%) developed metabolic syndrome.

Men with metabolic syndrome showed a 71% increased risk for mortality of all causes and cancer progression compared to men without metabolic syndrome. Average survival time was slightly higher for men without (average 22.3 months) than for men with metabolic syndrome (average 14.7 months). Time until cancer progression was significantly longer in men without metabolic syndrome (average 9 months) than in men with metabolic syndrome (average 4.7 months). Cardiovascular events (such as a stroke or heart attack) were noted to occur approximately equally among the two groups studied (in 15% of men).

Side effects related to abiraterone acetate treatment (such as low red blood cells, fatigue, chest infection, joint pain, and fluid retention) were similar among men with or without metabolic syndrome (reported in about 5% of men).

The researchers concluded that metabolic syndrome increases the risk of cancer progression in hormone-resistant prostate cancer patients.

Larger studies examining metabolic syndrome in advanced prostate cancer over longer periods of time are needed to confirm the preliminary results of this study.

Discuss the risks of metabolic syndrome with your doctor.