Men diagnosed with localized prostate cancer usually have a number of treatments options open to them. However according to a new study conducted by researchers at Boston’s Brigham and Women’s Hospital for those men, who already suffer from coronary artery disease induced congestive heart failure the use of hormone therapy, either alone or in conjunction with radiation treatments, may increase their overall risk of death.

For many men, brachytherapy is used in the treatment they receive for prostate cancer. This is a process by which radioactive “seeds” are implanted in the diseased prostate. This delivers a high dose of radiation to treat the affected tissues while sparing the surrounding areas from any harmful effects of the radiation.

In addition to this therapy doctors often add a course of hormone therapy. One of the purposes of this is to limit pubic arch interference which improves the effectiveness of the brachytherapy.

Previous research had concluded that the addition of hormone therapy to a course of brachytherapy treatment improved the survival rate in otherwise healthy patients but at the study’s conclusion its authors noted that the effect of other diseases upon this benefit was unknown. That is what the new study set out to discover.

The study set out to monitor 5,077 men of “median age”, 69.5 years, who had been diagnosed with localized or locally advanced forms of prostate cancer. Some received the hormone therapy in conjunction with the radiation while others followed a radiation only course of treatment. The treatments occurred between 1997 and 2006, with all study participants then being followed until 2008.

During the time frame of the study 419 men eventually died. Of those 200 men had no apparent history of any underlying co morbidity, 173 had one known coronary artery risk factor and 43 had known coronary artery disease that led to congestive heart failure or a heart attack.

Analysis of the data led researchers to conclude that the use of hormone therapy seemed to cause no increase in the risk of death for those men with no co morbidity factors or for those with a single heart disease risk factor, even after being followed up for a period of four years.

For those with a history of congestive heart failure caused by coronary artery disease it was a different story though. After the four year follow up period the hormone therapy was associated with nearly twice the risk of mortality – 26.3 percent in the men who had undergone hormone therapy versus 11.2 percent in those that had not.

The study was published in the August 26^th edition of JAMA.