Almost 3 years ago, while being prepped for surgery for a small bowel obstruction, my ECG showed I was having a 'heart attack' that wasn't. Instead I was later diagnosed with Brugada Syndrome (BrS), a genetic defect of the Sodium channels in the heart that can trigger a Sudden Cardiac Arrest (SCA). This was all quite a surprise to me, but not much changed for me, other than aggressively treating fever and now having a real reason to think I might just keel over and die at any time.
In the meantime, I was diagnosed this past April w/PCa, and since then I have become a bit obsessed w/following things medical in both domains (PCa & BrS). So I just came across this recent article frontiersin.org/articles/10... a long piece that explores possible interactions between BrS and many other conditions. Square in the middle is a section "Brugada Syndrome, Testosterone, and Prostate Cancer" In the middle of that paragraph is this sentence:
Men with Brugada-like electrocardiogram patterns have a higher risk of prostate cancer independent of age, smoking habit, and radiation exposure, and thus, men with either a Brugada-like ECG or prostate cancer should be checked for the other (145).
Now, since 1/6 men will have PCa and about 1/2500 will have BrS, it makes sense for BrS men to be screened for PCa (that is, even more so than the general population, but that is another rathole). I am not sure that it makes sense for all PCa men to be screened for BrS, since the target is so small. However, any of you PCa guys with a history of syncope (fainting), dizzy spells, Ventricular tachycardia, or resting bradycardia OR with a family history of sudden unexplained death at any age (including SIDS) may want to consider this testing.
Most commonly the first symptom of BrS is SCA. Talk about a surprise!
Written by
Vynbal
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Thank you for the information. I never thought that Brugada syndrome could cause prostate cancer.
I am a prostate cancer patient (Gleason 4+3) currently undergoing ADT (2 days in). I will be treated with HDR brachytherapy a month later, followed by five sessions of SBRT a month after that. I also have Brugada-like EKG which was discovered 15 years ago.
So as it turned out, my choice of treatment was directly affected by my BrS. When having my surgical consult, I brought with me a paper on Peri-operative Considerations for patients with Brugada Syndrome. As I started to explain surgical precautions I would need, the surgeon stopped me saying that I would be equally likely to be cured with radiation as with surgery, so he said, "If it were me, I would just do radiation". I had Proton Therapy to the pelvic region with an integrated boost to the prostate. The alternative was therapy similar to yours - BT + EBRT, but BT would also entail anesthesia, which I was trying to avoid due to the BrS. I also had 6 months of ADT. Again the BrS was a factor. Lupron/Eligard is known to exacerbate LongQT, which is a related arrythmia condition to BrS. After getting my MO and EP to discuss my case, they agreed to use Orgovyx (it was just approved a few months earlier) which could be stopped very quickly, and I had weekly EKGs for the first month (biweekly the second month), to check for worsening heart rhythm. Fortunately I had no complications.
have you ever had any fainting episodes in the past? All the cardiologists I have seen said that I have the brugada like EKG, but I do not have Brugada syndrome, cause I don’t have the history.
I have anesthesia three times - 2 for colonoscopy and 1 for prostate cancer biopsy.
No, I have never had any symptoms. My EP just has me on precautionary care - mindful of Na-Blocking drugs and fever, and on alert for any symptoms. I had two surgeries last year for bowel obstruction. The anesthesia team was prepared and took precautions, but I had no adverse reactions.
Were there any side effects, particularly cardiovascular ones, while you were on Orgovyx? Did you notice any differences in your EKG? I believe you were on it for six months?
I was on Orgovyx for 6 months. The weekly EKGs showed a steadily increasing QT interval, but it leveled off after 4 weeks at still a safe level. There were no noticeable (i.e. physical changes I could feel) CV side effects. There were the typical SE from T loss - ED, no libido, muscle loss, mental fog, fatigue, but I was mostly spared hot flashes, and I actually lost weight through extensive walking and intermittent fasting. I did have two less common SE - muscle cramps in my hands and middle-of-the-night insomnia, i.e. I would fall asleep OK, but wake up at 2am and could not fall back to sleep. If you'd like to talk more, send me a PM.
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