In a nutshell
This study aimed to compare the risk of cardiovascular incidents (CIs, side-effects) of surgical castration versus castration achieved by hormone therapy. The study concluded that CIs were higher for surgical treatment at 1.5 years after treatment, but similar thereafter.
Some background
For locally advanced or metastatic prostate cancer the standard of care is androgen deprivation therapy. This reduces the hormone testosterone that is involved in cancer growth. This can be achieved through medical means (GnRH agonists) or through a surgery called orchiectomy (removal of testes). It is unclear which method has the least risk in terms of cardiovascular incidents (CIs), such as heart attacks or strokes.
Methods & findings
This study looked at the records of 3,578 orchiectomy patients and 11,137 hormone therapy patients. These patients were all in Taiwan and were followed for 3-17 years.
The risk of CIs was 40% higher in the orchiectomy group than in the hormone therapy group during the first 1.5 years of follow-up. After 1.5 years the risk was similar. The risks were higher in the first 1.5 years for patients over than 65 years, who had high blood pressure or who had a history of CIs.
The bottom line
This study found the risk of CIs was higher in the orchiectomy group than in the hormone therapy group during the first 1.5 years of follow-up but was similar after 1.5 years.
The fine print
This study was carried out in Taiwan and may not be applicable to the US.
What’s next?
Discuss this study with your doctor if you have advanced prostate cancer and a risk of cardiovascular incidents.
Published By :
Journal of clinical oncology
Date :
Oct 02, 2017
