Mitigating Androgen Deprivation Therapy Cardiovascular Risk Factors in nmCRPC

Alicia K. Morgans, MD, MPH, an associate professor of Medicine at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University Feinberg School of Medicine, discusses how to handle cardiovascular risk factors associated with androgen deprivation therapy (ADT) in men with non-metastatic castration-resistant prostate cancer (nmCRPC).

According to Morgans, mitigating cardiovascular risk factors in this population should be a multidisciplinary approach, involving a urologist, oncologist, cardiologist, and primary care doctor. The National Comprehensive Cancer Network (NCCN) has devised guidelines around mitigating these guidelines.

The guidelines consist of 4 points. According to Morgans, patients must be made aware of the problem, address blood pressure, ensure smoking cessation and cholesterol management, and diet and diabetes education.

0:08 | I think that's so important and really, from my perspective is best achieved by a multidisciplinary approach whenever possible, involving a urologist and either a primary care doctor, a cardiologist, or the medical oncologist. And those same partners work as a team to really use a systematic approach to addressing reversible risk factors. The NCCN has devised some guidelines around this as well and supports what I always refer to as the ABCD approach, which has been published in some cardiology literature as well. And this first starts with awareness of the problem, talking to the patient about that issue, using aspirin when appropriate, and the guidelines there have changed which is another reason to really engage with the cardiologist on that particular issue. Addressing blood pressure for B, ensuring cigarettes smoking cessation and cholesterol, for C. D is diet and diabetes education and exercise as well, so really trying to come at this from a multidisciplinary and multifactorial approach. But there are multiple risk factors that we know affect our cardiovascular risk and if we can use the systematized approach and reverse them, many patients will actually have better outcomes.