New research from the UK and Sweden suggests that men with prostate cancer have an increased risk of developing thromboembolisms or blood clots, particularly if they are undergoing hormone therapy; the researchers believe they are the first to find such a link and hope this results in increased monitoring of prostate cancer patients.
You can read a paper about the research performed by first author Mieke Van Hemelrijck, a PhD student from the Division of Cancer Studies at King’s College London, and colleagues from various Swedish research institutes, in the 14 April early online issue of The Lancet Oncology.
The authors wrote in their background information that the link between cancer and developing blood clots is well established: in fact a person with cancer is about four times more likely to develop a blood clot than a healthy person.
However, the underlying mechanisms are not well understood, and evidence relating to specifically to prostate cancer is scarce, although studies have suggested that men undergoing endocrine therapy for prostate cancer are more likely to develop blood clots.
Using 1997 to 2007 data from the PCBaSe Sweden, a database that draws on the National Prostate Cancer Register (NPCR) of Sweden, Van Hemelrijck and colleagues assessed the risk of developing thromboembolic disease in Swedish men who were receiving treatment for prostate cancer with that of men in the general population.
Sweden’s NPCR records more than 96 per cent of all newly diagnosed prostate cancers and has follow up data on each patient.
For their analyses, the researchers investigated three types of thromboembolic disease: deep vein thrombosis (DVT), pulmonary embolism, and arterial embolism; and three types of cancer treatment: endocrine treatment (30,642 patients), curative treatment (26,432), or just surveillance (19,526).
During the 10-year period of study, 1,881 thromboembolic events were reported, and the researchers presented the results of their analysis in terms of standardized incidence ratios (SIRs), which compares the observed incidence of thromboembolic diseases in the patient cohort with that which would be expected if those patients reflected the incidence found in the Swedish male population at large.
They found that:
- Men with prostate cancer were signficantly more likely to develop thromboembolic disease than men without prostate cancer.
- All three treatment groups (endocrine, curative, surveillance) were at greater risk of developing DVT and pulmonary embolism, but not arterial embolism.
- Men undergoing endocrine therapy showed the highest risk of DVT.
- They were 2.5 times more likely to have a DVT than the general population (SIR 2.48, with 95 per cent Confidence Interval CI ranging from 2.25 to 2.73), and nearly twice as likely to develop a pulmonary embolism (SIR 1.95, CI 1.81 to 2.15).
- This risk was especially high for younger men (
The researchers suggested these results indicate that “… prostate cancer itself, prostate cancer treatments, and selection mechanisms all contribute to increased risk of thromboembolic disease”, and concluded that:
“Thromboembolic disease should be a concern when managing patients with prostate cancer.”
Funds for the study came from the Swedish Research Council, Stockholm Cancer Society, and Cancer Research UK.
“Risk of thromboembolic diseases in men with prostate cancer: results from the population-based PCBaSe Sweden.”
Mieke Van Hemelrijck, Jan Adolfsson, Hans Garmo, Anna Bill-Axelson, Ola Bratt, Erik Ingelsson, Mats Lambe, Pär Stattin and Lars Holmberg.
DOI:10.1016/S1470-2045(10)70038-3
Source: Kings College London.
Written by: Catharine Paddock, PhD