Anyone Begin Having Heart Trouble Potentially Caused by PCA Treatment?

[JamesAtlanta]

I was diagnosed with PCA in May 2015, age 53, PSA of 227, Gleason 4+4=8. 1 spinal met in T8 vertebra. Immediately started Lupron, radiation to T8, then early chemo and later added Zytiga (and recently had prostatectomy). PSA is undetectable...and I’m still working full time and doing very well.

The issue I have is that at some point after I started treatment, my heart rate will no longer go above 120 beats per minute. This causes me to be out of breath walking up hills or taking more than 1 flight of stairs, or even walking off a plane when it’s on a steep jetway. But I can still ride my Peloton 10 miles per day, walk 3-4 miles at a time, etc... I just cannot go as fast as would be normal for someone my age. As recently as late 2014, I could run with no issues, which is why I think the condition, called chronotropic incompetence, was caused by some part of my treatment

Anyway, I’m wondering if anyone on this forum has had this phenomenon. I have had a detailed coronary exam and they say that other than an inability to get my heart rate up, all is fine. I’m having a pulmonary capacity and performance test at MD Anderson on Thursday. They are hypothesizing that maybe I sustained some sort of scarring of the lungs due to the radiation treatment. If that comes back as ‘normal’, then I’ll probably just have to live with it. If they think that is the cause, I may qualify for a clinical trial.

Would appreciate learning more about any similar experiences anyone else may have had.

Best,

James

[Tall_Allen]

Are you taking alpha or beta blockers? You can ask your RO what was the dose/volume constraint set for the heart and lungs.

[JamesAtlanta in reply to Tall_Allen]

I have not had any alpha or beta blockers. Unfortunately my RO is retired now. But I presume I can still get my records from his office to find the answer to your question.

Thanks for the quick response. You are always incredibly helpful!

Best,

James

[Tall_Allen in reply to JamesAtlanta]

Just ask for the heart and lung dose constraints and a copy of the Dose/Volume Histogram with heart and lungs as organs at risk. They should be able to print out a copy.

[Mkeman]

I developed atrial fib after being on Eligard for a year and Zytiga/prednisone for six months. The condition was not there prior to the therapy. I had trouble getting my heart rate up during a stress test, too. But it was attributed to the blood pressure drug I am taking. The warning sheets for cancer drugs typically list cardiac problems as a potential side effect.

[notjohn in reply to Mkeman]

Sorry about your heart problems. I developed a-fib around the same time I started ADT. My heart will flip into afib and run at 150+ bpm for hours. Luckily I seem to always “convert” back to sinus rhythm on my own. I haven’t needed to get “shocked” back into a sinus rhythm yet.

My cardiologist is hesitant to prescribe meds for it because the side effects are relatively bothersome in lyounger patients ( I’m 49 and in fairly good shape ). I’m on the waiting list for ablation therapy to address the afib.

Both my cardiologist and my oncologist say there’s no persuasive data showing a link between ADT (I’m on firmagon) and the onset of afib. It could just be a coincidence.

[pjoshea13 in reply to notjohn]

My wife developed A-fib 13 years ago. Needed to go to the ER & was told she would be on the drug they prescribed forever. A month or so passed & the drug wasn't so effective anymore. Doctor told her to double the dose. & that became ineffective too.

I found a study that suggested taurine & arginine.

She took 2 grams of taurine & 1 gram of arginine 4 times a day at first (on an empty stomach). She had basic control within a week. Quickly decreased dosage to once daily. Has been fine for 12 years.

Nalakrats tells a similar story.

Worth trying. Safe & cheap.

-Patrick

[Desanthony in reply to pjoshea13]

Patrick,

Never thought I would get help for AFib here! Thanks. I had a successful cardioversion back in May so I do not need anything other than apixaban at the moment- thankfully because alpha blockers, beta blockers and calcium blockers just made me poorly. However, I have a friend who has suffered for years from AFib and nothing seems to help so this might help her.

Thanks for all your informative posts.

Des

[Hidden in reply to pjoshea13]

I would add a couple to the two you mentioned: CoQ10 and Magnesium. I also take L-acetyl Carnitine. a-fib runs in my family. I've been dealing with it for at least 20 years prior to my PC diagnosis. Prescription drugs weren't controlling it very well. Rythmol did the trick but put me in atrial-flutter. Got a flutter ablation (shorter operation and waiting list and not quite as invasive as a-fib ablation). Now it is under very good control. Stress and dehydration can aggravate a-fib. I'm convinced that lying on my left side to sleep sometimes triggered an episode but that hasn't been an issue since I lightened the daytime pill intake and bumped the evening dosage.

[Hidden in reply to notjohn]

I hope you at least pop a couple of aspirins when you go into a-fib, or are on another blood thinner. Stroke is a risk when in a-fib.

[notjohn in reply to Hidden]

Thanks for the advice . Yes, I’m doing the low dose ASA but no other drugs

[Desanthony]

Chemo can cause heart problems and some people think that Hormone treatment can to - though there seems to be no conclusive evidence. My brother-in-law had 14 weeks of chemo for gullet cancer last year and was put on bisoprolol almost immediately because of the likelihood that the chemo can cause heart problems. I am not sure if he is still on it but he was for some time after the chemo. When you speak to cardio nurses they tell you that they have lots of people with heart probems after chemo or radiotherapy at their clinics and classes though I was never told about any link between radiotherapy and heart problems or hormone therapy and heart problems but 4 months after my radiotherapy and hormone therapy I was diagnosed with atrial fibrillation. So what the cardio nurses are seeing at their classes and referrals seems to be borne out by my experience.

[Bluebird11]

I will never understand why doctors so isolate and compartmentalize the body. It doesn’t make sense. After the first 4 years of on and off ADT not one doc thought to look at my husband’s heart. The heart is a muscle. When there’s muscle wasting from meds why wouldn’t the heart be involved?

Not in these specific cases, but my point being it is one body. Genie

[Hidden in reply to Bluebird11]

They don't give a darn about 'small' inconveniences like gynecomastia either.

[Vitaminlover]

My husband has been on ADT( firmagon and Zytiga) for only a month yet he feels a skipped beat and his resting heart rate is very low ( he is not an athlete). Holter monitor did not show any problems but cardiologist lowered one of his BP pills and that seemed to help.

[dorke]

Hi,

When I started ADT my GP told me it may impact cardiovascular functions so she asked me to do a ECG after a while on ADT.

The ECG that I did showed electrical signals that may indicate left ventricular hipertrophy -LVH- which is a serious condition.The GP sent me right away to do an echo cardiogram.

to my relief it didnt show any hipertrophy but..

it showed a minimal pericardial effusion.

I was sent to do a second echo cardiogram two weeks later since in many cases pericardial effusion resolves by itself (idiopathic pericardial effusion) and indeed the second echo came out clear.

About two months after starting ADT I began having palpitations.I can really fell skipping a heart beat.

Definetly for me, ADT is messing around with my heart/nervous system

[JamesAtlanta in reply to dorke]

Thanks for the reply - appreciate you sharing. I suspect many of us will experience some of these side effects... and learn to live with them.

Best wishes in your journey!

Best,

James

[ARIES29]

Yes James Atlanta, I was wondering when somebody would mention this. I had one Luprin shot & 5 months of ADT & half way through it started to have chest pains & headaches also. Went to a GP here & everything is ok? but still have slight tightening in chest area so a cardio specialist is next step.

I might add i would not take the ADT after this experience & my MO told me not to see him any more so had first Lutetium 177 recently.

[j-o-h-n]

to JamesAtlanta:

Timing! I'm on hormones and this past Monday my cardiologist said that he will fit me with a cardio halter monitor in a couple of weeks.... I hope it will not clash with the color of my man boobs bra.

Good Luck and Good Health.

j-o-h-n Wednesday 09/19/2018 7:19 PM EDT

[GeorgeGlass]

James, how ya been doing after your surgery?

Regarding the heart rate. Try 2-4 grams of L-arginine powder about 20-30 minutes before your cardio workout and see what happens. I have coronary artery disease and use the L-arginine before workouts. I usually have trouble and angina when I get to 120 beats per minute but on the l-Arginine I get my bpm up to 150 without much trouble or angina pain. The amino acid dialates your arteries which is why it is so affective. It causes a nitric oxide increase in your body which is great for your exercise performance.

George

[JamesAtlanta]

Good to hear from you, George! I’m doing great. Completely recovered from my surgery! Thanks for asking!

My only issue (other than being on ADT for 4-years) is my inability to get my heart rate up above about 118bpm. I’ll give your suggestion a try. And I’m having a consult with Cleveland Clinic for my heart in July. So hopefully they will have some insight.

PSA still undetectable - Life is good!

How are you doing? Wishing you all the best!

Best regards,

James