Heart Palpitations on ADT

[Dino]

Hi Fellas,

 

Wondering if anyone has experienced unexplained heart palpitations while on ADT.

I have a long history of a benign heart arrythmia called PVC's. It comes and goes but hadn't had a problem

for over 5 years. Suddenly after 7 months on Lucrin, the condition has reoccurred that bad I spent the night 

in the ED of the hospital recently with dizziness and breathing difficulties. Worst episode ever. Because of my Pca

and treatment they thought I had a blood clot in my lung, for which a CT scan came back clear.

A blood test showed mild anemia,which could be a contributing factor. Will see a Cardiologist soon . EKG, chest Xray,

Troponin blood test all normal. All Dr in ED said was that I was at high risk for DVT and cardio problems because of ADT.

Sometimes I wonder if the fear of dropping dead of a heart attack while I'm out running is worse than an early death from Pca.!

 

Cheers Dino

[Admin]

Dino

If you have cardiovascular disease, your doctor may consider using the hormone treatment (ADT) Firmagon, also called Degarelix.

 

Firmagon showed greater safety for cardiovascular health in this study:

Cardiovascular morbidity agonists and antagonist Albertsen 2014.pdf

 

All the best

Jim

[Admin]

Firmagon is an GnRH antagonist (or LHRH antagonist).

All other injectable or implant ADTs are GnRH agonists (LHRH agonists).

 

I am on Firmagon myself.

Call me if you wish to chat.

 

Jim

[alanbarlee]

G'day Dino,

 

I've been on Zoladex and generic Avodart for the past 9.5 years, 5 years after diagnosis and RP (PSA 6 / GS 4+3 at age 61) For the last 3.5 years Zytiga and Panafcort. have been added to this cocktail. PSA is currently 0.1 (at age 74).

 

Around 2.5 years ago I began having brief but increasingly frequent dizzy spells (in my case, pre-syncope), which culminated in sudden blackouts and collapse (syncope). Cardiology visits resulted in ECG, echocardiogram and 7-day event monitor testing, followed by an unambiguous diagnosis of paroxysmal (in and out) atrial fibrillation. 

 

A pacemaker was installed very quickly after the diagnosis, supported by an anti-arrhymic drug (sotelol) and an oral anti-coagulant drug (apixaban), which all together have successfully controlled the arrhythmia and syncope, at the expense (combined with the effect of the prostate cancer drugs) of faster loss of muscle mass and decreased physical tolerance to such activities as walking up stairs and hills, as well as a mild increase in periodic fatigue during the day.

 

Another small issue with multiple morbidities is the 'polypharmacy' one - multiple drugs needing checks for potential drug-drug and drug-food interactions, as well as an effective compliance system. 

 

AF is a very under-diagnosed condition, especially in our age group, so it's worth checking out this possibility.

 

Good luck.

 

Alan 

[Paul Edwards]

Dino, your pre-existing heart condition probably meant that you were at high risk of cardiovascular side effects from androgen deprivation therapy.  It's disappointing that you had to spend a night in the Emergency Department before this was identified. You certainly need a cardiologist on your medical team and, possibly, an endocrinologist.

 

The following tables are from an article Androgen Deprivation Therapy Complications by CA Allan and others in the August 2014 issue of the journal Endocrine Related Cancers.

 

 

Table 1

Adverse effects of ADT

  Short-term  Reduced quality of life including mood and cognition  Hot flushes  Sexual dysfunction (loss of libido and erectile dysfunction)  Increased fat mass and loss of skeletal muscle  Increased total, LDL, HDL cholesterol and TG levels  Hyperinsulinaemia Long-term  Osteoporosis and fracture  Type 2 diabetes mellitus  Cardiovascular disease

 

(I disagree with the way that side effects are classified as short term or long term - in my experience they're all long term!)

 

 

Table 2

Managing cardiovascular risk in men receiving ADT

  Lifestyle modification to prevent weight gain (especially abdominal)  Dietary  Exercise Smoking cessation Optimise blood pressure control Screen for and treat hyperlipidaemia Screen for and treat type 2 diabetes mellitus Aspirin therapy with established cardiovascular disease (role in primary prevention uncertain)

 

To read the full article, click on this link.

[Bruce Kynaston]

Dino,

My question is, do you really need ADT?

I was treated with EBRT 20 years ago, but at a TURP for poor flow 3years ago, 40% of removed tissue showed Gleason 9 PCa.

My PSA has been rising slowly for several years and is 18 but I have no symptoms but feel generally well for my age of 85.

I have no desire to upset my situation by risking symptoms from ADT.

So, I wonder whether you need to consider treating the rising PSA or avoiding the risk of problems such as you are now experiencing.

Should you have a chat with your GP for starters?

Best wishes,

Bruce.

[Dino]

Hi Bruce,

 

Thanks for your reply.

 

With recurrent Pca 6 years after ERBT in the prostate and metastatic spread to a pelvic lymph node and PSA 15 and rising, 

 

unfortunately I do need ADT according to my Onco. But I'm hoping he'll let me go intermittant when I see him next on 24th May.

 

Good on you for being on top of it for so long, you are certainly an inspiration!

 

Cheers Dino

[Dino]

Thanks Jim,Alan and Paul for all your replies and the information you've provided.

 

I really appreciate all the support on this site. I shouldn't complain,there are men much worse than me!

 

I guess sometimes we all need to vent a bit of frustration at times!

 

Thanks again,

 

Dino