Cardiovascular Effects of Androgen Deprivation Therapy for the Treatment of Prostate Cancer

A journal club article review presented by Thomas Keane, MD. “Cardiovascular Effects of Androgen Deprivation Therapy for the Treatment of Prostate Cancer: ABCDE Steps to Reduce Cardiovascular Disease in Patients with Prostate Cancer”.   

Written by: Nirmanmoh Bhatia, Marilia Santos, Lee W. Jones, Joshua A. Beckman, David F. Penson, Alicia K. Morgans and Javid Moslehi

In this presentation of the journal article listen for key considerations on androgen deprivation therapy (ADT) and the risk of cardiovascular events, ABCDE algorithm that may reduce CV disease, recommendations for CVD screening and monitoring and CVD event risk with GnRH antagonist treatments. 

Abstract: Case Presentation: A 74-year-old man with a new diagnosis of locally advanced prostate cancer is referred to the cardio-oncology clinic for optimization of his cardiovascular health after treatment with degarelix, a gonadotropin-releasing hormone (GnRH) receptor antagonist, for his prostate cancer. Two years ago, he had a myocardial infarction resulting in placement of a drug-eluting stent in his proximal left anterior descending artery. He has had no recurrent symptoms but lives a sedentary lifestyle. An electrocardiogram showed normal sinus rhythm. His most recent echocardiogram demonstrated a structurally normal heart with normal left ventricular ejection fraction. He takes aspirin 81 mg daily. He has hypertension, with the last recorded blood pressure of 160/90 mm Hg, and he is currently treated with metoprolol 25 mg twice daily and lisinopril 40 mg daily. He has diabetes mellitus that is treated with glipizide 10 mg daily, and his last hemoglobin A1c level was 7.4 mg/dL. He is also treated with pravastatin 40 mg daily; his low-density lipoprotein was 120 mg/dL at his most recent clinic visit. He continues to smoke 1 pack of cigarettes daily, and his body mass index is 30 kg/m2.

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Thomas E. Keane, MBBCh, FRCSI, FACS, is Professor and Chairman of the Department of Urology at the Medical University of South Carolina in Charleston. Dr. Keane specializes in managing prostate, bladder, and renal cancers.

An avid researcher, Dr. Keane has served as principal investigator or coinvestigator on more than 20 major clinical and preclinical studies, funded by grants from the National Institutes of Health as well as industry-funded. Much of his work focuses on innovative concepts in translational research, including utilizing human tumor xenografts to investigate the efficacy of new therapies as they relate to GU malignancies with particular reference to cytotoxic agents, sphingolipids, and boron-containing compounds. He holds a U.S. patent for sphingolipid derivatives and their use