Hormonal Therapy for Localized and Androgen Deprivation Therapy and Cardiovascular Disease Risk

Despite the development of a variety of novel agents for the treatment of advanced and metastatic prostate cancer, the only therapeutic option for this stage of the disease is androgen-deprivation therapy. Cardiovascular Disease (CVD) is one of the most common causes of death worldwide and the most usual in the western populations. Although it affects both sexes, it is more frequent in males in whom it shortens the average life expectancy. Traditionally, this difference has been attributed to the testosterone effect. However, the incidence of conventional risk factors for cardiovascular disease increases as men ages while testosterone levels decreases. Several studies associated lower circulating testosterone levels with conditions that predispose to CVD such as excess abdominal fat, increased carotid intima-media thickness, loss of insulin sensitivity, diseases such as diabetes and metabolic syndrome, atherosclerosis and aortic and lower limb arterial disease as well. Moreover current evidence demonstrated that this hormone has protective effects on the cardiovascular system, however still there are no solid proofs of an association between low testosterone levels and CVD related death risk in Prostate Cancer (PC) patients receiving androgen-deprivation therapy (either surgical orchiectomy or medical). In the present article we discuss the association between androgen deprivation therapy and cardiovascular disease risk emphasizing the increased risk for thromboembolic events in prostate cancer patients.