Saving Hearts and Lives in Advanced Prostate Cancer: Choosing Between ADT Agonists and Antagonists – Tweetorial Archive Segment 1

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Epidemiology and Treatment

The National Cancer Institute estimated that there would be 248,530 new cases of prostate cancer (PCa) in 2021, and 34,130 deaths. Most cases of PCa are diagnosed between 65 and 74 years of age (median: 67 years old), and the risk of diagnosis increases with age until about 70 years of age.


Although PCa is the second most commonly diagnosed cancer in the United States, effective monitoring and screening has resulted in declining incidence and mortality rates that have remained stable since 2013.


The older age of patients who are diagnosed with PCa also comes with comorbidities, the number of which increases with age. In a database study of a Scottish population (N = 1,751,841), 42% had ≥1 chronic morbidity while 23% had multimorbidity (≥2 disorders). This study also found that 50% of the population had at least 1 morbidity by age 50 and multimorbidity by age 65.


Cardiovascular disease (CVD) is the leading cause of death in the United States and is of particular concern in older adults. In fact, the prevalence of CVD has been found to increase with age, affecting 54% of men ≥20 years of age and 78% of men 60 to 79 years of age. Additionally, 1 in 3 men with PCa also have high CVD risk.


There are several available treatment options for men with PCa. Androgen deprivation therapy (ADT), in particular, is a mainstay of PCa treatment; systemic treatment with gonadotropin-releasing hormone (GnRH) agonists or antagonists are the preferred choice for most men. Orchiectomy is also an option, but its irreversibility may make it a poor choice for some patients.