It’s a fact: even healthy men get prostate cancer (PCa), the most common tumor cancer in males. Of course, those with obvious risk factors (family history of breast or prostate cancer, exposure to toxins, ethnic/racial factors) are more prone to develop this disease, but sometimes cancer strikes a healthy person with no known predisposition or vulnerability.

Sneaky risk factors

If you are a PCa patient who considers yourself healthy, are you as robust as you think? Are you inadvertently putting yourself at increased risk of heart disease? A new study out of Canada suggests that many PCa patients are not taking as much control of their cardiovascular wellness as they should. The published article by Klimis, et al. (2023)^[i] reports their surprising finding that “…nearly all patients (99%) with prostate cancer had at least 1 uncontrolled modifiable risk factor, and more than half (51%) had 3 or more uncontrolled modifiable risk factors.”^[ii] This may well explain the saying that PCa patients are more likely to die of something else; in this case, heart disease may kill them well before PCa is the cause of death.

The risk factors for cardiovascular disease can sneak up on you. Having a busy life makes it easy to overlook or skip measures that are shown to preserve a strong heart and high-functioning circulatory system. The Canadian authors analyzed the cases of 2,811 PCa patients. They found that at least 98% had at least one poorly controlled risk factor, while a 50% had at least three of the following modifiable cardiovascular risk factors:

• High LDL cholesterol (the “bad” cholesterol)
• Smoking
• Lack of physical activity/exercise
• High blood pressure
• Waist-to-hip ratio greater than 0.9 (abdominal obesity or “belly fat”
• Hyperglycemia (high blood sugar)

Initially, not one of these factors is painful in itself. If the demands of life are stressful, it’s easy to make excuses like “An occasional cigarette makes me feel less tense” or “I’m too busy to make it to the gym.” Some of these factors go undetected for years, doing silent damage, especially if the intention to go for a physical continues to slip through the cracks.

Sadly, the Klimis study found that 3 simple interventions that could prevent cardiovascular disease were the most neglected in their population: statin use, medications to lower blood pressure, and lack of physical workouts/activity. Whatever happened to the saying, “An ounce of prevention is worth a pound of cure”?

Special importance for high-risk PCa

While maintaining a strong heart is important for every man, it’s especially so for PCa patients with higher risk disease. They are more likely to eventually be treated with androgen deprivation therapy (ADT) to control—but not cure—their cancer. ADT blocks the effect of testosterone to help control PCa, but the drugs used for it can compromise cardiovascular health even in men with no pre-existing cardiovascular disease.^[iii] The situation is worse for those with 3 or more of the above risk factors.

With an aggressive cancer, the clock is ticking, yet guidelines recommend that heart health be managed before beginning ADT. And yet, according to one commentary reflecting on the medical community, “…we still have a very long way to go before meeting that optimization ideal.”^[iv]

Each patient’s responsibility

Therefore, it is up to each PCa patient to maintain a lifestyle that maximizes cardiovascular health, before, during, and after treatment. At the Sperling Prostate Center, we support wellness for the whole person, not only to minimize PCa risks, but to have a long and happy life with high quality. The heart— and prostate—you save is your own.

 

NOTE: This content is solely for purposes of information and does not substitute for diagnostic or medical advice. Talk to your doctor if you are experiencing pelvic pain, or have any other health concerns or questions of a personal medical nature.

References

[i] Klimis H, Pinthus JH, Aghel N, Duceppe E et al. The Burden of Uncontrolled Cardiovascular Risk Factors in Men With Prostate Cancer: A RADICAL-PC Analysis. JACC CardioOncol. 2023 Jan 17;5(1):70-81
[ii] Moningi S, Nguyen PL. Uncontrolled Cardiovascular Risk Factors in Prostate Cancer Patients: Are We Leaving Too Much on the Table? JACC CardioOncol. 2023 Feb 21;5(1):82-84.
[iii] Moningi, ibid.
[iv] Moningi, ibid.