Influence of Androgen Suppression Therapy for Prostate Cancer on the Frequency and Timing of Fatal Myocardial Infarctions
Open accessAbstract
Purpose: We evaluated whether the timing of fatal myocardial infarction (MI) was influenced by the administration of androgen suppression therapy (AST). Patients and Methods: The study cohort comprised 1,372 men who were enrolled onto three randomized trials between February 1995 and June 2001. In the three trials, the men were randomly assigned to receive radiation therapy with 0 versus 3 versus 6, 3 versus 8, or 0 versus 6 months of AST. Fine and Gray's regression was used to determine the clinical factors associated with the time to fatal MI, and estimates of time to fatal MI were calculated using a cumulative incidence method. When comparing the cumulative incidence estimates using Gray's k-sample P values, increased weight was ascribed to the earlier data because recovery of testosterone is expected for most men within 2 years after short-course AST. Results: Men age 65 years or older who received 6 months of AST experienced shorter times to fatal MIs compared with men in this age group who did not receive AST (P = .017) and men younger than 65 years (P = .016). No significant difference (P = .97) was observed in the time to fatal MIs in men age 65 years or older who received 6 to 8 months of AST compared with 3 months of AST. Conclusion: The use of AST is associated with earlier onset of fatal MIs in men age 65 years or older who are treated for 6 months compared with men who are not treated with AST.
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Hormonal therapy side effects include hot flashes, osteoporosis, anemia, fatigue, sarcopenia, gynecomastia, loss of libido, erectile dysfunction, diabetes risk, cardiovascular disease risk, fatal cardiac events, and possible emotional distress.
“These side effects include: hot flashes, osteoporosis, anemia, fatigue, sarcopenia, gynecomastia, loss of libido, erectile dysfunction, risk of diabetes, risk of cardiovascular disease and fatal cardiac events as well as possible emotional distress [9–13].”
From Prostate cancer: Psychosocial implications and management (2008) · cites this paper as [13]
The Introduction associates androgen suppression therapy with anemia, insulin resistance, and increased diagnoses of cardiac disease. The Discussion reports earlier fatal myocardial infarctions in men aged 65 or older receiving the therapy. Our copy does not substantiate the sentence’s other listed effects, such as hot flashes, osteoporosis, sexual dysfunction, or emotional distress; no page numbers are available in the indexed passages. (LLM, conf=0.88)
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- Authors
- D'Amico, A. V., Denham, J. W., Crook, J., Chen, M.-H., Goldhaber, S. Z., Lamb, D. S., Joseph, D., Tai, K.-H., Malone, S., Ludgate, C., Steigler, A., & Kantoff, P. W.
- Affiliations
- Brigham and Women's Hospital (US)
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2007-06-10
- Volume
- 25
- Issue
- 17
- Pages
- 2420-2425
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2165990809
- Cited by
- 501
- References
- 34
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 8 · 2023: 8 · 2022: 17 · 2021: 14 · 2020: 17 · 2019: 12 · 2018: 17 · 2017: 19 · 2016: 27 · 2015: 18 · 2014: 26 · 2013: 32 · 2012: 50
- FWCI
- 43.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Treatment and Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
- Keywords
- androgen deprivation therapy, prostate cancer, fatal myocardial infarction, older men, testosterone recovery, radiotherapy, cumulative incidence, age as risk factor
- MeSH terms
- Age Factors, Aged, Androgen Antagonists, Humans, Male, Middle Aged, Myocardial Infarction, Prostatic Neoplasms, Risk Factors, Randomized Controlled Trials as Topic
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