Monday, September 26, 2022

Prostate Cancer And Heart Disease

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Tips To Promote A Healthy Prostate

How Are Heart Disease and Prostate Cancer Related?

The prostate gland in men is responsible for a variety of functions, like producing seminal fluid and ensuring strong bladder function. An unhealthy lifestyle coupled with aging can cause this gland to enlarge, resulting in mens urinary incontinence. Because of a weak prostate, you are likely to look at road trips as a series of restroom stops. Whether you have to go to a friends house for poker or to a grocery store, you may feel as if youre always on the lookout for the nearest bathroom. In other words, a weak or unhealthy prostate can make life miserable and inconvenient. Thats why you need to implement better habits for a healthy prostate.

Fortunately, good eating habits and a regular exercise routine can ensure you dont experience any prostate problems. And if youre already suffering from a weak bladder or other prostate issues, these lifestyle changes can prevent these conditions from getting worse.

Here are a few tips from your ally against male urinary incontinence and for a healthy prostate:

Outcome Measure And Assessments

The primary endpoint was time to first Major Adverse Cardiovascular Events after the start of treatment for prostate cancer. MACE was defined as myocardial infarction, stroke, unstable angina requiring intervention, or cardiovascular death. The start date of treatment was defined as the start of ADT for patients who had received RT and ADT and the start of RT for RT only patients. Time to MACE was censored at the initiation of palliative systemic therapy when patients developed recurrence or metastases. Alive or lost to follow-up patients without recurrence, metastases or MACE were censored at their date of the last follow-up.

Data Source: Korean National Health Insurance Service Database

The Korean National Health Insurance Service is a single-government payer which provides a mandatory public health insurance program to virtually the entire Korean population . The remaining 3% of the population with the lowest income is covered by the Medical Aid program financed from general taxes, but the administration for these people is also covered by the NHIS. Medical services are mainly provided by private providers, and they are reimbursed from the KNHS for their service provision.

The KNHIS also provides a free biennial cardiovascular health screening program to all Koreans over 40 years of age and to those who are employed regardless of age. This program consists of anthropometric measurements , health behavior assessment , and laboratory tests .

Therefore, the KNHIS database, contains all the information necessary for reimbursement of each medical service, and includes beneficiary information medical claims information and national health screening data.

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Relative Risk Model For Specific Causes

The FineGray model of competitive risk is used to examine the associations between prognostic factors and heart disease mortality or PCa-specific mortality in patients receiving RT or RP . With each 5-year advance in age, the risk of heart-specific death gradually increased from 0.44 to 4.38 . In addition, patients who received a diagnosis of PCa between 2006 and 2012 had a significantly lower risk of heart-specific death, relative to those with diagnoses in the years 2000 to 2005 .

Table 3. All-cause, heart-related, and prostate-related mortality of patients by demographic and clinical characteristics at diagnosis.

Compared with Caucasians, African-American patients had a higher risk of heart-specific death , while patients of other ethnicities had a lower risk .

The risk of heart-specific death in patients with histologic subtypes other than adenocarcinoma was the same as that for adenocarcinoma . Compared with patients with local disease, those with regional showed a significantly higher risk of heart-specific death . However, the risk of heart-related death in patients with distant disease was significantly less relative to local disease . Compared with patients who underwent RP, those who received RT had a significantly higher risk of heart-specific death .

Table 4. Heart-related mortality in patients with PCa of various cancer stages who underwent RP or RT at diagnosis, analyzed by age and treatment subgroup.

Why Do I Need To Pay Attention To My Heart Health

Pin by Andrew Morley on Semester 2

It may be surprising, but many factors that increase your chances of developing heart disease are also common in men with prostate cancer. This means, as a man with prostate cancer, you are likely at a higher risk of suffering from conditions like heart attacks, strokes and other types of heart disease.

Your risk of developing heart disease may also be increased by some common treatments for prostate cancer. It’s a good idea to talk to your prostate cancer doctor about your heart health when you start a new treatment.

Recommended Reading: Next Generation Prostate Cancer Risk Calculator

Clinical Assessment Of Prostate Cancer Patient

Due to the relatively high prevalence of CV complications of PC treatment, we strongly emphasize that every patient should undergo a careful clinical assessment before starting any anticancer procedures. The scope and intensity of such supervision should be based on a variety of factors such as age, type of anticancer drug, patients current and prior CV status, other comorbidities, and concomitant medications. Every patient aged 70 + should undergo geriatric screening. The most reliable screening tool according to the International Geriatric Oncology Society guidelines is the G8 scale, which identifies patients who could benefit from comprehensive geriatric assessment and geriatric consultation. It also helps in choosing the appropriate intensity of PC treatment plan as decisions should be made on the basis of health status evaluation and not according to chronological age . Regular cardio-oncology evaluation is strongly recommended. Current CV comorbidities should be well-controlled and optimally treated. Before the initiation of any anticancer procedures, every patient should be screened for hypertension, dyslipidemia, and prediabetes/diabetes. Electrocardiography and transthoracic echocardiography should also be performed at baseline and before every subsequent treatment line. If CV complications occur, the decision on management should be based on cancer prognosis , life expectancy, and patients preferences .

What Causes Heart Disease

Coronary heart disease, also referred to as hardening of the arteries, is caused by the build up of fatty material and other substances, such as cholesterol, on the walls of your coronary arteries causing them to narrow. This build-up can slow down or stop the flow of blood and oxygen to your heart. If your heart doesnt get enough blood and oxygen, you could have a heart attack.

Too much bad cholesterol is a major risk factor for heart disease.

Sadly, the risk of heart disease increases with age, and you are also at risk if you are genetically predisposed to it. However, there are certain things you can do to prevent it.

Research has determined that diabetes, cholesterol, lack of exercise, smoking, high blood pressure, stress and having a stroke can increase your risk of contracting heart disease. So, to prevent heart disease, dont smoke limit your alcohol intake engage in at least 30 minutes of exercise a day get treated for stress and depression manage your cholesterol levels and maintain a healthy weight.

A healthy diet is also critical for heart disease prevention. Eat more fruits, veggies, lean proteins, whole grains and low-fat dairy, while avoiding salt and saturated fat and eating fewer cholesterol-laden foods, such animal products.

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Sex Hormones And Hot Flushes

Some cancer treatments can lower the levels of sex hormones in the body. The sex hormones are oestrogen and progesterone in women, and testosterone in men. The cancer treatments include hormone treatments for prostate cancer.

Prostate cancer needs testosterone to grow. Hormonal treatments aim to:

  • stop the testicles from making testosterone
  • stop testosterone reaching cancer cells

Research suggests that low levels of testosterone can cause heart problems and diabetes in men. There are some ideas about why this might be but more research needs to be done looking into this.

Correlation Between Prostate Cancer And Cardiovascular Disease

Depression and the risk of cardiovascular disease among prostate cancer patients

Transcript:

John L. Fox, MD, MHA: There is certainly a strong connection between cardiovascular disease and prostate cancer. We know that cardiovascular disease is the leading cause of death in men with prostate cancer. I think the real question is, is there an increased risk of cardiovascular disease in men with prostate cancer? There are a number of studies that have demonstrated that men with preexisting cardiovascular disease are at a higher risk of subsequent cardiovascular morbidity and mortality compared to those without disease. In fact, there was a study published in 2020 that showed that two-thirds of men initiating treatment for prostate cancer had preexisting cardiovascular disease or cardiovascular risk factors. So while theres not a clear causal relationship that indicates that treatment for prostate cancer increases the risk of cardiovascular death, I think theres circumstantial evidence that suggests that patients treated with GnRH therapies are at increased risk. And it may be that patients who are treated with GnRH agonists are at even higher risk, and we can talk about some of that evidence this morning.

Transcript edited for clarity.

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American Heart Association News Stories

American Heart Association News covers heart disease, stroke and related health issues. Not all views expressed in American Heart Association News stories reflect the official position of the American Heart Association. Statements, conclusions, accuracy and reliability of studies published in American Heart Association scientific journals or presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect the American Heart Associations official guidance, policies or positions.

Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved. Permission is granted, at no cost and without need for further request, for individuals, media outlets, and non-commercial education and awareness efforts to link to, quote, excerpt or reprint from these stories in any medium as long as no text is altered and proper attribution is made to American Heart Association News.

Other uses, including educational products or services sold for profit, must comply with the American Heart Associations Copyright Permission Guidelines. See full terms of use. These stories may not be used to promote or endorse a commercial product or service.

Hormone Therapy And Heart Disease

Hormone therapy had no significant impact on death rates in men who had no other known illnesses or who had a single risk factor for heart disease. Smoking history and family history of heart disease were not evaluated in this study.

But over an average follow-up of five years, men with a history of coronary-artery-disease-related congestive heart failure or heart attack were twice as likely to die if they had been treated with hormone therapy.

“Our results would suggest that hormonal therapy should not be used in these men or that their underlying heart disease should be addressed before they are considered for hormonal therapy,” lead author Akash Nanda, MD, PhD, of Harvard University’s Brigham and Women’s Hospital, Dana-Farber Cancer Institute, tells WebMD.

Nanda was quick to point out that just 5% of the patients in the study — 256 men in all — had established heart disease, suggesting that the treatment may still offer a survival advantage to most men with poor-prognosis prostate cancer who are eligible for it.

But American Cancer Society deputy chief medical officer Len Lichtenfeld, MD, tells WebMD that questions remain about the risks vs. benefits of hormone therapy prior to radiation in men with risk factors for heart disease, such as poorly controlled diabetes, high cholesterol, and high blood pressure.

“It would be helpful to have additional studies that address this issue in men with one or more risk factors for heart disease,” he says.

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Prostate Cancer Treatment May Raise Heart Risks

WEDNESDAY, July 27, 2022 — Hormone therapy is a common treatment option for prostate cancer, but it may increase the risk of death from heart disease, especially in older men, a new study finds.

Dr. William Dahut, a prostate cancer researcher and chief scientific officer for the American Cancer Society, said the study from Lithuania provides more evidence that starting hormonal therapy requires careful thought, particularly if the patient is over 70 and has heart disease.

“There are some cases where it’s clear men need hormonal therapy,” Dahut said, citing prostate cancer that has spread. “But oftentimes it’s used for patients that are newly diagnosed, that are receiving radiation or with men that have a rising PSA without cancer that we can see, something called biochemical recurrence.”

In terms of biochemical recurrence, “it needs to be looked at very carefully because there’s much less data there that hormonal therapy will have an impact on how long patients live from prostate cancer,” said Dahut, who was not involved in the study.

Doctors should consider whether to use hormonal therapy or how long to use it on a case-by-case basis, Dahut noted.

Hormone therapy, or androgen deprivation therapy, is considered a mainstay treatment for patients who have either high-risk localized prostate cancer or advanced cancer that has metastasized.

Still, what can doctors do to treat one serious disease while not exacerbating another?

© 2022 HealthDay. All rights reserved.

What Information Can I Take To My Doctors Appointment

Potential Cardiometabolic Risks With Prostate Cancer Treatment

You’ll get more out of your visit if you go prepared. Set aside some time to gather information about your cancer, general health and treatments, and questions you want to ask.

Ideas:

  • Read about the risks on this page and let your doctor know if you think they apply to you.

  • Plan to talk with your doctor about your prostate cancer treatment and how it may impact your heart.

  • If you have a couple of weeks before your visit, gather information about your current health, write it down, and bring it to your visit. For example:

    â Check your blood pressure twice a week using a home machine or a public machine at a drugstore.

    â Check your weight and think about how much youâve weighed over the last couple of years.

    â Make notes about how many times a week you exercise and how you like to stay active.

    â Use a calorie tracker to understand more about your diet, if youâre trying to lose weight.

The following experts contributed to the development of this page:

Scott Bauer, MD, ScM University of California, San Francisco and San Francisco VA Medical Center

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What Is Benign Prostatic Hyperplasia

Benign prostatic hyperplasia, or BPH, is an enlargement of the prostate that is not due to a malignant growth. Its a common problem and risk increases with age. For example, in Australia men aged 45 have roughly 1 in 17 chance of developing BPH, while men aged 75 years and over have a 1 in 4 chance.

Even though the growth is benign, BPH can still cause problems. As the prostate gets bigger, it can press on the urethra and slow or even prevent the flow of urine, in a similar way to bending a hose stops the flow of water.

Variable symptoms of BPH may include:

  • Increased urine frequency.

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Early Prostate Cancer Treatment Carries Heart Risk

Hormone-suppressing regimen may raise odds for heart failure, but it brings benefits, too, researchers say

HealthDay Reporter

FRIDAY, Aug. 25, 2017 — Because testosterone can help prostate tumors grow, men with prostate cancer are often given hormone-suppressing treatment.

But new research suggests that delivering the treatment in prostate cancer’s early stages may, in turn, hike a man’s odds for another illness — heart failure.

The treatment in question is known as androgen-deprivation therapy.

The take-home message from the new study is that “patients with localized prostate cancer should be followed to minimize the health effects of androgen-deprivation therapy on the cardiovascular system,” said study author Reina Haque. She’s a researcher with the Kaiser Permanente Southern California Department of Research & Evaluation.

Haque’s advice? “Patients should consider lifestyle changes, and physicians should actively monitor the patient’s health for early signs of heart disease,” she said in a Kaiser Permanente news release.

A prostate cancer expert who reviewed the study agreed.

“This new data is important in deciding what treatment should be undertaken, if any, for early stage disease,” said Dr. Elizabeth Kavaler, a urology specialist at Lenox Hill Hospital, in New York City.

However, the safety and effectiveness of androgen-deprivation therapy for these men hasn’t been investigated, the study authors said.

Study author Haque agreed.

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American Heart Association Issues Statement On Cardiovascular Side Effects From Hormonal Therapy For Prostate Cancer

  • By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases

Thanks to early detection and better treatments, the five-year survival rate for prostate cancer is 99%. Hormonal therapies, which are given to roughly half of all men with prostate cancer, have done much to extend lifespans. These drugs suppress testosterone, a hormone that prostate tumors need to grow. But they also come with challenging side effects, including metabolic problems linked to cardiovascular diseases.

In April, the American Heart Association issued a statement addressing cardiovascular risks from hormonal therapy. Of particular importance, the authors emphasized, is the need to identify men with pre-existing cardiac risk factors or a family history of cardiovascular diseases who should be monitored closely during treatment.

The statement goes into extensive detail on the different types of hormonal therapies and what is known about their cardiac side effects.

One class of these drugs, called GnRH agonists , blocks testosterone by a rather circuitous route: GnRH agonists trigger the brain’s pituitary gland to secrete high amounts of two substances, luteinizing hormone and follicular stimulating hormone . Elevated LH levels will trigger a surge in testosterone production by the testes. And to compensate for that hormonal flare , the pituitary gland reduces its LH output, which causes testosterone levels to plummet.

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