Skip to main content

Advertisement

SpringerLink
Log in

New study suggests patients with advanced prostate cancer on androgen deprivation therapy need more dialogue with health care provider, especially around cardiovascular risk

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To study the current level of patients’ awareness, and patient-health care provider (HCP) dialogue with respect to treatment-related risks, especially cardiovascular risk (CVR) associated with advanced prostate cancer (PCa) treatment.

Methods

This 10-min online survey summarised data by treatment, region, and CVR (high or low).

Results

Of the 411 patients, 83% were at high CVR while only 8% patients were aware of CVR associated with PCa treatment, majority of which (80%) were informed about this risk by HCPs. No significant difference in treatment approach was reported, regardless of patient’s CVR status. Compared to other potential risks, patients were more likely to initiate discussion about heart problems with HCPs (38% patients). When prompted, 26% patients rated heart problems as the most concerning risk factor, and this concern was twice in patients with high CVR (28%) versus low CVR (14%). Lifestyle modifications were made by 64% patients, of which 45% patients reported an improvement in overall well-being. Improved diet was the most adopted lifestyle modification.

Conclusion

There is a need to enhance a constant patient–HCP dialogue, and both groups need to make a conscious effort in that direction. This would help in increasing patients’ awareness of risks, having better treatment choice and acceptance, and reducing side-effects.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Prostate cancer statistics [Internet]: Centers for Disease Control and Prevention, CDC (US). Updated on 23 May 2017. https://www.cdc.gov/cancer/prostate/statistics/index.htm. Accessed 19 Jan 2018

  2. Key statistics for Prostate cancer [Internet]. American Cancer Society. https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html. Accessed 19 Jan 2018

  3. Tao ZQ, Shi AM, Wang KX, Zhang WD (2015) Epidemiology of prostate cancer: current status. Eur Rev Med Pharmacol Sci 19:805–812

    PubMed  Google Scholar 

  4. Fu AZ, Tsai H-T, Haque R, Yood MU, Cassidy-Bushrow AE, Van Den Eeden SK, Keating NL, Smith MR, Zhou Y, Aaronson DS, Potosky AL (2017) Mortality and androgen deprivation therapy as salvage treatment for biochemical recurrence after primary therapy for clinically localized prostate cancer. J Urol 197:1448–1454

    Article  CAS  PubMed  Google Scholar 

  5. Greiman AK, Keane TE (2017) Approach to androgen deprivation in the prostate cancer patient with pre-existing cardiovascular disease. Curr Urol Rep 18:41

    Article  PubMed  Google Scholar 

  6. Keating NL, O’Malley AJ, Freedland SJ, Smith MR (2010) Diabetes and cardiovascular disease during androgen deprivation therapy: observational study of veterans with prostate cancer. J Natl Cancer Inst 102:39–46

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Saigal CS, Gore JL, Krupski TL, Hanley J, Schonlau M, Litwin MS, Urologic Diseases in America Project (2007) Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer. Cancer 110:1493–1500

    Article  CAS  PubMed  Google Scholar 

  8. Levine G, D’Amico AV, Berger P, Clark PE, Eckel RH, Keating NL, Milani RV, Sagalowsky AI, Smith MR, Zakai N (2010) Androgen deprivation therapy in prostate cancer and cardiovascular risk: a science advisory from the American Heart Association, American Cancer Society, and American Urologic Association: endorsed by the American Society for Radiation Oncology. Circulation 121:833–840

    Article  PubMed  PubMed Central  Google Scholar 

  9. Tsai HK, D’Amico AV, Sadetsky N, Chen MH, Carroll PR (2007) Androgen deprivation therapy for localized prostate cancer and the risk of cardiovascular mortality. J Natl Cancer Inst 99:1516–1524

    Article  PubMed  Google Scholar 

  10. Haque R, UlcickasYood M, Xu X, Cassidy-Bushrow AE, Tsai HT, Keating NL, Van Den Eeden SK, Potosky AL (2017) Cardiovascular disease risk and androgen deprivation therapy in patients with localized prostate cancer: a prospective cohort study. Br J Cancer 117:1233–1240

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Davis MK, Rajala JL, Tyldesley S, Pickles T, Virani SA (2015) The prevalence of cardiac risk factors in men with localized prostate cancer undergoing androgen deprivation therapy in British Columbia, Canada. J Oncol 2015:820403. https://doi.org/10.1155/2015/820403

    Article  PubMed  PubMed Central  Google Scholar 

  12. Keating NL, O’Malley AJ, Freedland SJ, Smith MR (2013) Does comorbidity influence the risk of myocardial infarction or diabetes during androgen-deprivation therapy for prostate cancer? Eur Urol 64:159–166

    Article  PubMed  Google Scholar 

  13. Crawford ED, Moul JW (2015) ADT risks and side effects in advanced prostate cancer: cardiovascular and acute renal injury. Oncology 29(55–58):65–66

    Google Scholar 

  14. Gandaglia G, Sun M, Popa I, Schiffmann J, Trudeau V, Shariat SF, Trinh QD, Graefen M, Widmer H, Saad F, Briganti A, Montorsi F, Karakiewicz PI (2015) Cardiovascular mortality in patients with metastatic prostate cancer exposed to androgen deprivation therapy: a population-based study. Clin Genitourin Cancer 13:e123–e130

    Article  PubMed  Google Scholar 

  15. Snow SL, Panton RL, Butler LJ, Wilke DR, Rutledge RDH, Bell DG, Rendon RA (2007) Incomplete and inconsistent information provided to men making decisions for treatment of early-stage prostate cancer. Urology 69:941–945

    Article  PubMed  Google Scholar 

  16. Sommers BD, Beard CJ, D’Amico AV, Kaplan I, Richie JP, Zeckhauser RJ (2008) Predictors of patient preferences and treatment choices for localized prostate cancer. Cancer 113:2058–2067

    Article  PubMed  Google Scholar 

  17. Nguyen PL, Chen MH, Hoffman KE, Chen RC, Hu JC, Bennett CL, Kattan MW, Sartor O, Stein K, D’Amico AV (2012) Cardiovascular comorbidity and treatment regret in men with recurrent prostate cancer. BJU Int 110:201–205

    Article  PubMed  Google Scholar 

  18. Song L, Bensen JT, Zimmer C, Sleath B, Blackard B, Fontham E, Su LJ, Brennan CS, Mohler JL, Mishel M (2013) Patient-health care provider communication among patients with newly diagnosed prostate cancer: findings from a population-based survey. Patient Educ Couns 91:79–84

    Article  PubMed  PubMed Central  Google Scholar 

  19. EAU Guidelines. Edn. presented at the EAU Annual Congress Copenhagen 2018

  20. Van Hemelrijck M, Garmo H, Holmberg L, Ingelsson E, Bratt O, Bill-Axelson A, Lambe M, Stattin P, Adolfsson J (2010) Absolute and relative risk of cardiovascular disease in men with prostate cancer: results from the Population-Based PCBaSe Sweden. J Clin Oncol 28:3448–3456

    Article  PubMed  Google Scholar 

  21. Levine GN, D’Amico AV, Berger P, Clark PE, Eckel RH, Keating NL, Milani RV, Sagalowsky Zakai SN (2010) Androgen-deprivation therapy in prostate cancer and cardiovascular risk. Circulation 121:833–840

    Article  PubMed  PubMed Central  Google Scholar 

  22. Teoh JY, Chan SY, Chiu PK, Poon DM, Cheung HY, Hou SS, Ng CF (2015) Risk of cardiovascular thrombotic events after surgical castration versus gonadotropin-releasing hormone agonists in Chinese men with prostate cancer. Asian J Androl 17:493–496

    CAS  PubMed  Google Scholar 

  23. Chen DY, See LC, Liu JR, Chuang CK, Pang ST, Hsieh IC, Wen MS, Chen TH, Lin YC, Liaw CC, Hsu CL, Chang JW, Kuo CF, Huang WK (2017) Risk of cardiovascular ischemic events after surgical castration and gonadotropin-releasing hormone agonist therapy for prostate cancer: a nationwide cohort study. J Clin Oncol 35:3697–3705

    Article  CAS  PubMed  Google Scholar 

  24. O’Farrell S, Garmo H, Holmberg L, Adolfsson J, Stattin P, Van Hemelrijck M (2015) Risk and timing of cardiovascular disease after androgen-deprivation therapy in men with prostate cancer. J Clin Oncol 33:1243–1251

    Article  CAS  PubMed  Google Scholar 

  25. Iacovelli R, Ciccarese C, Bria E, Romano M, Fantinel E, Bimbatti D, Muraglia A, Porcaro AB, Siracusano S, Brunelli M, Mazzarotto R, Artibani W, Tortora G (2018) The Cardiovascular Toxicity of Abiraterone and Enzalutamide in Prostate Cancer. Clin Genitourin Cancer 16:e645–e653

    Article  PubMed  Google Scholar 

  26. Latorzeff I, Ploussard G, Guillotreau J, Jonca F, Labarthe P, Rollin G, Beauval JB, Pathak A (2016) Cardiovascular risks with prostate cancer hormonal treatment: rationale for a department of oncocardiology. Cancer Radiother 20:405–410

    Article  CAS  PubMed  Google Scholar 

  27. Bhatia N, Santos M, Jones LW, Beckman JA, Penson DF, Morgans AK, Moslehi J (2016) Cardiovascular effects of androgen deprivation therapy for the treatment of prostate cancer: ABCDE steps to reduce cardiovascular disease in patients with prostate cancer. Circulation 133:537–541

    Article  PubMed  PubMed Central  Google Scholar 

  28. Knight SJ, Latini DM (2009) Sexual side effects and prostate cancer treatment decisions: patient information needs and preferences. Cancer J 15:41–44

    Article  PubMed  Google Scholar 

  29. Watson E, Shinkins B, Frith E, Neal D, Hamdy F, Walter F, Weller D, Wilkinson C, Faithfull S, Wolstenholme J, Sooriakumaran P, Kastner C, Campbell C, Neal R, Butcher H, Matthews M, Perera R, Rose P (2016) Symptoms, unmet needs, psychological well-being and health status in survivors of prostate cancer: implications for redesigning follow-up. BJU Int 117:E10–E19

    Article  PubMed  Google Scholar 

  30. Fourcade RO, Mensink P, Ernemo B, Ligensa C (2002) The value of patient–doctor dialog in the treatment of early prostate cancer. Prostate Cancer Prostatic Dis 5:S12–S14

    Article  PubMed  Google Scholar 

  31. Hardy C, Penn S, Morris T (2007) Attitudes of prostate cancer patients towards the diagnosis and treatment of their disease: findings from a multinational survey. Curr Med Res Opin 23:2107–2116

    Article  PubMed  Google Scholar 

  32. Basaria S (2012) Time to raise awareness regarding complications of androgen deprivation therapy. Asian J Androl 14:175–176

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Schostak M, Wiegel T, Müller M, Hoecht S, Schrader M, Straub B, Bottke D, Hinkelbein W, Miller K (2004) Shared decision-making—results from an interdisciplinary consulting service for prostate cancer. World J Urol 22:441–448

    Article  CAS  PubMed  Google Scholar 

  34. Patel HR, Mirsadraee S, Emberton M (2003) The patient’s dilemma: prostate cancer treatment choices. J Urol 169:828–833

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Double Helix, Baker Street, London, for supporting the survey. Medical writing support was provided by Tania Peshin and Payal Bhardwaj (Tata Consultancy Services), both funded by Ferring.

Funding

This online survey was conducted by Healthcare Market Research agency Double Helix and was funded by Ferring Pharmaceuticals.

Author information

Authors and Affiliations

  1. University Hospital Schleswig-Holstein, Ratzeburger Allee 160, 23538, Lübeck, Germany

    Axel Merseburger

  2. Ferring Pharmaceuticals, Kay Fiskers Plads 11, Copenhagen, Denmark

    Anne Bro Falkenberg

  3. Ferring International Center, Chemin de la Vergognausaz 50, Saint-Prex, Switzerland

    Olga J. Kornilova

Authors
  1. Axel Merseburger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anne Bro Falkenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Olga J. Kornilova
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

A Merseburger: scientific advisor; manuscript review. A Bro Falkenberg: project development including concept and design; manuscript review. O Kornilova: project development, data collection and management, data analysis, manuscript review.

Corresponding author

Correspondence to Axel Merseburger.

Ethics declarations

Conflict of interest

Axel Merseburger is the associate editor of WJU and has contributed to pharmaceutical companies like Amgen, Apogepha, Astellas, Bayer, BMS, Clovis, Ferring, Hexal, Ipsen, Janssen, Merck, MSD, Novartis, Roche, Sanofi, Takeda, TEVA. Anne Bro Falkenberg was an employee of Ferring Pharmaceuticals at the time of conduct of this survey. Olga Kornilova is an employee of Ferring Pharmaceuticals.

Statement of human rights

Patients participating in this anonymous online survey were asked for their agreement. Survey was conducted according to Market research industry code of conduct and privacy rights were respected in the analysis of results.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 472 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Merseburger, A., Bro Falkenberg, A. & Kornilova, O.J. New study suggests patients with advanced prostate cancer on androgen deprivation therapy need more dialogue with health care provider, especially around cardiovascular risk. World J Urol 37, 1085–1093 (2019). https://doi.org/10.1007/s00345-018-2495-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-018-2495-0

Keywords

Search

Navigation