Prostate cancer hormone therapy hard on the heart

By Megan Rauscher

NEW YORK (Reuters Health) – Men with recurrent or advanced
prostate cancer may be put on hormone therapy to block
testosterone production in an effort to halt or slow the growth
of the tumor. However, new research shows, this may put them at
increased risk for developing insulin resistance and elevated
blood sugar levels, which can affect heart health.

These complications of what doctors call
androgen-deprivation therapy or ADT may contribute to the high
rate of heart disease in men with prostate cancer,
Baltimore-based investigators report in the journal Cancer.

Roughly half of men who develop prostate cancer die of
other, unrelated causes, explain Dr. Shehzad Basaria from Johns
Hopkins University and colleagues. Heart disease is one of the
most common causes of death in men with prostate cancer.

In a study of 53 men with prostate cancer, the researchers
found that those treated with testosterone-lowering ADT for at
least one year were more resistant to the action of insulin –
the body’s key sugar-regulating hormone – and had higher
glucose levels than men who had only received local surgery
and/or radiation and had normal testosterone levels, and
age-matched healthy men with normal testosterone levels.

According to the study, 44 percent of men in the ADT group
had blood sugar levels greater than 126, which is among the
criteria for the diagnosis of diabetes. In contrast, only about
12 percent of men in the other groups had blood sugar levels
this high.

In an e-mail to Reuters Health, Basaria said: “If these
observations are confirmed in long-term prospective studies,
then insulin resistance and diabetes should be regarded as
additional side effects of androgen deprivation in these men.”

In the meantime, the investigators think men with prostate
cancer who have received ADT for at least one year should be
screened for high blood sugar.

More study, they add, is needed to determine the value of
anti-diabetes drugs in men with prostate cancer.

SOURCE: Cancer, February 1, 2006.