Prostate Cancer Patients
Prostate cancer is the most common cancer diagnosed in men in the United States. About 1 man in 7 will be diagnosed with prostate cancer during his lifetime. Prostate cancer usually occurs in older men. About 6 out of 10 are diagnosed in men aged 65 or older. Conversely, prostate cancer is rare before age 40. While prostate cancer is a common and serious disease, men diagnosed with prostate cancer generally do no die from it. Nearly 3,000,000 men in the United States who have been diagnosed with prostate cancer at some point with more than are still alive today.
Cardiovascular (heart and vascular) disease is common in prostate cancer patients and survivors for several reasons. Prostate cancer occurs at an age when men may already have cardiovascular disease or may have risk factors such as high blood pressure, high cholesterol, and diabetes mellitus. In fact, many prostate cancer patients actually die of heart disease rather than prostate cancer itself. In addition, several treatments for prostate cancer can have harmful effects on the heart and vessels. For example, inhibiting the male sex hormones (collectively called androgens) is an important means of treating prostate cancer. However, this hormone therapy (also called androgen deprivation therapy [ADT]) is associated with an increased risk of diabetes mellitus and may make men more susceptible to cardiovascular disease, especially older men.
Exactly why ADT may increase the risk of heart disease is unclear. It is well known that ADT leads to decreased muscle mass and strength, bone loss with possible development of osteoporosis, increased cholesterol levels, and hot flashes. Weight gain, due to a 10% to 20% increase risk of total body fat, is an underemphasized side effect of ADT. Gaining weight puts men at risk of developing several cardiac risk factors, including high blood pressure, high cholesterol, and diabetes mellitus. These changes can increase the risk of cardiac diseases such as heart attack, heart failure, or heart rhythm irregularities.
For these reasons, all prostate cancer patients should be aware of heart disease risk and should discuss these risks with their doctors. Prevention of heart disease is the best strategy in fighting heart disease. Specifically, the ABCDE schematic for cancer survivors apply particularly to prostate cancer patient and breast cancer survivors.