Hormone Therapy for Early Prostate Cancer Not Always Best

Aug. 26 -- TUESDAY, Aug. 25 (HealthDay News) -- Men who have been diagnosed with prostate cancer and who also have underlying heart disease may not benefit from treatment with hormones, new research suggests.

In fact, such hormone therapy may actually increase their odds of dying.

"For men who've had a prior heart attack or heart failure, use of hormone therapy for prostate cancer was associated with a shortened lifespan," said study author Dr. Akash Nanda, a radiation oncology resident with the Harvard Radiation Oncology Program at Brigham & Women's Hospital/Dana-Farber Cancer Institute in Boston. The report appears in the Aug. 26 issue of the Journal of the American Medical Association.

The findings essentially change the risk-benefit profile when deciding which treatment suits which patient, and could change practice fairly quickly, said Dr. Ronald D. Ennis, director of radiation oncology at St. Luke's-Roosevelt Hospital Center and associate director of Continuum Cancer Centers of New York in New York City.

Although more studies are needed, Ennis added, "many of us are concerned enough about this issue that, for a while, we might start to use this information in our decision-making, especially for people for whom hormone therapy is not indicated or needed."

"I think this is going to make people even more conservative in their use of hormones than when researchers started to identify who benefited," added Dr. Eric M. Horwitz, acting chairman of the radiation oncology department at Fox Chase Cancer Center in Philadelphia. "We had always thought that there might be cardiac problems with long-term use of hormones, but this shows that even a short course can be harmful."

Hormone therapy, when used with radiation therapy, can increase survival in more aggressive cases of prostate cancer. But this benefit tended to shrink in men who also suffered from other conditions.

Until now, however, experts have not known which other conditions were responsible for the jump in risk.