Michael G. Kirby, MBBS, FRCP, presented “Cardiovascular Implications in the Treatment of Prostate Cancer” during the 33rd International Prostate Cancer Update on January 24, 2023, in Vail, Colorado.

How to cite: Kirby, Michael G. “Cardiovascular Implications in the Treatment of Prostate Cancer.” January 24, 2023. Accessed Jun 2024. https://grandroundsinurology.com/cardiovascular-implications-in-the-treatment-of-prostate-cancer/

Cardiovascular Implications in the Treatment of Prostate Cancer – Summary

Michael G. Kirby, MBBS, FRCP, discusses cardiovascular implications of androgen deprivation therapy (ADT). Professor Kirby explains prostate cancer treatment choices have become complex, sharing Prostate Cancer UK Best Practice Pathway—Prostate Cancer: Treatment by Risk Stratification. Professor Kirby focuses on the cardiovascular risks, pointing out that cardiovascular disease is the second leading cause of death in men with prostate cancer and the primary cause of death in men with T3 or lower-stage disease.

Professor Kirby enumerates ways ADT adversely impacts cardiovascular risk factors, such as obesity, insulin sensitivity, and serum lipoproteins. Loss of testosterone may increase aortic stiffness, promote arterial wall thickness, and cause endothelial dysfunction which promotes the formation of atherosclerotic plaque. He outlines ways testosterone protects the cardiovascular system, causing coronary vasodilation, maintaining plaque stability, having an antiarrhythmic effect, and shortening the QT segment.

Professor Kirby then stresses the importance of behavioral and pharmacologic risk management because second-line ADT agents (abiraterone acetate and enzalutamide) both show cardiovascular safety signals. He advocates for a proactive, multidisciplinary effort to effectively communicate with patients and their primary care physicians as well as including team members such as physical therapists, specialists, and social workers, among others. Finally, Professor Kirby explains the ABCDE steps to reduce risk of cardiovascular disease in prostate cancer patients.

 

About The 33rd Annual International Prostate Cancer Update:
The International Prostate Cancer Update (IPCU), founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. The 33rd iteration of the meeting occurred January 22-25, 2023 in Vail, Colorado. To view more educational presentations from IPCU 33, visit our collection page.