2024

Robert H. Eckel, MD, FAHA, FACC, FNLA, outlines common cardiovascular risks in prostate cancer patients on androgen deprivation therapy (ADT). Dr. Eckel launches his talk by explaining the most common non-prostate cancer cause of death in men with metastatic prostate cancer is cardiovascular disease (CVD).

Dr. Eckel points out the potential molecular connections between CVD and prostate cancer. He illustrates tissue-specific effects in terms of adverse cardiovascular consequences of various ADTs.

Dr. Eckel displays data on adjusted hazard ratios of cardiovascular events in prostate cancer patients with and without ADT exposure and points out ADT increases risk of heart failure in men without preexisting CVD. He points out chemotherapy and immunotherapy are also associated with increased CVD risk and shares a science advisory on ADT and CVD risk, outlining factors to examine such as obesity, serum lipids, insulin sensitivity, blood pressure, waist-hip ratio, and C-reactive protein.

Dr. Eckel explains there is no formalized approach for identification or stratification of cardiovascular risk or tools to reduce risk. He describes a multidisciplinary panel tasked with considering the challenges in managing cardiovascular risk in men with prostate cancer on ADT.

Dr. Eckel summarizes the panel’s recommendation of an assessment tool that identifies CVD risks for men with prostate cancer, which can be exacerbated by treatment. He explains that urologic oncology providers comfortable managing CVD risk factors are empowered to do so and highlights the importance of communication and the “village” of providers (e.g. cardiologists, PCPs, etc.) who may be involved in comprehensive care. He emphasizes these risks are not static and reassessment and follow-up must be ongoing.