Journal of Andrology Testis Workshop 2009
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Published-Ahead-of-Print January 22, 2009, DOI:10.2164/jandrol.108.006924

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EFFECT OF ANDROGEN SUPPRESSION COMPARED TO ANDROGEN RECEPTOR BLOCKADE ON ARTERIAL STIFFNESS IN MEN WITH PROSTATE CANCER

Frances Dockery *, Christopher J. Bulpitt , Sanjiv Agarwal , Clare Vernon , and Chakravarthi Rajkumar

* To whom correspondence should be addressed. E-mail: fdockery{at}doctors.org.uk.

Endogenous testosterone and oestradiol are thought to be cardio-protective in men. We wanted to determine the effects of two different anti-androgen therapies on arterial stiffness as one suppresses (Goserelin - a Gonadotrophin-Releasing Hormone analogue) while the other increases (Bicalutamide - an androgen-receptor blocker) both testosterone and oestradiol. We conducted a randomised trial on 43 men (mean age 71.2±6.2 years) with localized prostate cancer. They received either goserelin or bicalutamide for 24 weeks. Carotid-Femoral (C-F) and Carotid-Radial (C-R) pulse wave velocities (PWV) were measured. Twenty age and disease-matched men with prostate cancer on no active treatment were studied in a similar manner. After 12 weeks of goserelin, radial artery PWV increased significantly from baseline and a non-significant increase was observed in femoral PWV (change from baseline radial: +1.4m/s, p=.002, femoral: +0.9 m/s, p=.127) Both PWV measures increased significantly with bicalutamide (change from baseline radial: +0.8, femoral: +0.9 m/s, p≤.049). PWV increased further after 24 weeks with goserelin (change from baseline radial: +1.7, femoral: +1.3 m/s, p≤.049 for both) but not bicalutamide (change from baseline radial: +0.4, femoral: +0.4 m/s, p=NS), however comparison of changes between the two drugs were not significantly different at either 12 or 24 weeks (p≥.967 at 12 weeks and p≥.07 at 24 weeks). The untreated men studied in parallel showed no changes at 12 or 24 weeks in either PWV measure. . In conclusion anti-androgen treatment in men with prostate cance may increase large artery stiffness, an adverse cardiovascular risk factor, however the effect was not maintained with testosterone receptor blockade in the longer term but tended to be sustained with suppression therapy. This may relate to the different sex hormone effects of the two therapies.


Key words: Androgen • Prostate • arterial • cancer • vascular






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