Article: ADT May Increase Risk of Death From Cardiovascular Disease in Prostate Cancer

[rsgdmd]

Conclusion: ADT recipients had a significantly increased risk of death from stroke and ischemic heart disease.

My thought: Maybe low dose aspirin isn't a bad idea when on ADT.

cancertherapyadvisor.com/ho...

[6357axbz]

All my docs including my cardiologists concur that low dose aspirin is a must for high risk cardiovascular patients, like me. Another reason to take an ADT holiday if possible.

[Magnus1964]

After 30 years of ADT drugs I finally had bypass surgery. I do think the ADT drugs were a factor. But I would not change the 30 years of cancer treatment to prevent heart disease.

[Bigmaristuff in reply to Magnus1964]

I just read your bio and you are saying that you were diagnosed with grade 4 Gleason 9 metastatic PC in 1992. That is absolutely amazing. You are obviously doing something right. Is it diet, supplements, meditation, exercise, or prayer ?... Please elaborate if you have a minute.

[Magnus1964 in reply to Bigmaristuff]

You are perceptive, All of the above. I became a vegan days after being diagnosed. After a few weeks I switched to vegetarian. Then a few years later I added fish to my diet.

Supplements are and have been a part of my life. Too numerous to mention here. I treat supplements like ADT drugs, when one fails move on to the next.

Attitude has a lot to do with Pca. Meditation, deep breathing exercises and guided imagery.

I have been fortunate in the timing of ADT drug development, i.e. Casodex to zytiga to xtandi.

I was also privaged to find DCA, a repurposed drug to fight Pca.

I can only hope the ORIC trial works for me.

[Bigmaristuff in reply to Magnus1964]

Thanks for confirming what I believe in my heart of hearts. All the best with your trial.👍

[MateoBeach]

Not a bad idea at all if your stomach is okay with it, especially enteric coated. Also a statin if lipids are not optimal. On the venous side (DVT and PE risk) Nattokinase appears to offer protection. And compression stockings for longer air and car travel.

[dac500]

My MO thinks ADT increases cardiovascular risk. That is why he wants me to take break from ADT. But my cardiologist told me that the risk is significant only when starting ADT. Later on the risk reduces. I have been on Lupron since 2018 (with two breaks). My blood works don't point towards increase cardiovascular risk. Many people on this forum think the risk is not high.

[Tall_Allen]

They are showing the relative risk in a retrospective population.The absolute risk is quite small.

[London441]

Henry Ford’s quote about money not changing men but merely unmasking them, so popular it’s been paraphrased and repackaged many times, is analogous here I think.

The number of men who start ADT having undiagnosed CVD or essentially no idea of their level of CVD risk is probably staggering. We hear that Pca is something we’ll ‘die with, not from’.

Which is true, and predominantly it’s CVD. It’s far more likely to kill us than prostate cancer, and still so many tend not to get heart calcification tests, no lipid panels, no stress tests, and usually little or no exercise.

Then they worry about the relatively puny chances of harm from 81 mg of daily aspirin, which helps. Or believe the YouTube folklore about the dangers of statins, which help more, and refuse them too. If any of these shoes don’t fit, then not directed at you.

If we know our numbers, know our risk, and take preventative action we can eliminate or at least delay not just CVD but all the co morbidities ADT hastens and exacerbates-and there are many.

Maybe if guys had to ignore their health knowingly they’d do it less.

Most old guy friends I’ve had a conversation with about my Pca since diagnosis are invariably sympathetic.

They also think they’re ‘fine’, and will never see a doctor until forced to.

[Hidden]

Aspirin is a COX-2 inhibitor, delays progression for both HSPC and CRPC. Especially effective If you have PTEN Loss. Ref.: research-information.bris.a...

[leebeth]

They did not look at men on GnRH antagonists, just agonists, according to the study.

[joeguy]

I developed a variety of heart issues while on Firmagon (sometimes Eligard) and Xtandi. Started with Tachycardia, then skipped and irregular beats and some shortness of breath. A heart cath showed a 70% blockage in the LAD. I was put on a variety of heart meds, and stopped all ADT for about a year. The Tachycardia, and irregular beats resolved very soon after stopping ADT. I assume the blockage is still present, but I have had no further episodes of shortness of breath. My cardiologist says if symptoms of the blockage return, we will look at doing a bypass (blockage not in good location for stint).

[Derf4223]

Its no coincidence that the Rx of exercise and a good diet apply equally to heart disease and PCa.