Androgen Deprivation Therapy-Mediated Cardiovascular Disease and Vascular Aging in Men with Prostate Cancer: Racial Difference and Role of NAD+
Abstract
Prostate cancer is the most common cancer in older men. However, heart diseases such as stroke and heart attack remain the most common cause of death 10 years following a cancer diagnosis. A lot of these heart issues happen in the first six months after starting hormonal treatment for prostate cancer. Black men tend to have a lot more of these issues compared to White men. A lot of these heart events are associated with non-medical factors that influence health outcomes (e.g., the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life). These non-medical factors are also known as social determinants of health. Age is one of the strongest predictors of heart events. Hormonal therapy can speed up aging and associated changes in the body. Aging is associated with a decline in a molecule in the body called nicotinamide adenine dinucleotide. This molecule is a building block for energy pathways in the human body. Through this study, we intend to study the role of the non-medical factors i.e., social determinants of health, in causing heart disease upon starting hormonal therapy in men with prostate cancer. In addition, we hope to find the biological reason for this increased risk of heart disease. This research will be able to tell us if hormonal therapy increases the aging of blood vessels in Black men compared to White men. We hope to also find out if the nicotinamide adenine dinucleotide molecule or social determinants of health play a role in the rapid aging process of hormonal therapy. In the following paragraph, we elaborate on the two aims of the study. This research can answer a lot of questions regarding the health of men with prostate cancer. When men with prostate cancer get started on hormonal therapy, they undergo testing to determine the risk of heart disease. This study will tell us whether the non-medical factors have a role to play in heart disease noted after starting hormonal treatment. We will explore this question more by finding which of the five non-medical factors have a stronger role to play. The non-medical factors we are looking at include access to quality education, access to healthcare, and social relationships. We are also studying the patient’s financial abilities and neighborhood. Through this study, we can pay closer attention to these non-medical factors while caring for men with prostate cancer to minimize the risk hormonal therapy may pose to their hearts. We live in the era of personalized medicine. This means that each patient is special. The current methods to assess the risk of heart disease with hormonal therapy do not differentiate between patients. In other words, it calculates the risk similarly for all men by considering certain risk factors such as cholesterol levels. Although paying attention to risk factors such as cholesterol levels is important, we believe we can do better at the individual level. We know that hormonal therapy may speed up the aging process, but it may not do it the same way for all men. Given what we know about Black men and heart disease, they likely age faster than White men when started on hormonal therapy. This observation may be related to the difference between social determinants of health entirely and not related to race. Thus, we propose looking at the aging process using special blood and cardiovascular tests. In addition, in this study, we will also examine the role of the energy molecule in the body called nicotinamide adenine dinucleotide. Given what we know about the ancestral differences in this molecule, it may be a reason why Black men age faster due to the addition of hormonal treatment for prostate cancer. This study is focused on advancing health equity and reducing racial disparities among men with prostate cancer. This study is being conducted at Georgia Cancer Center, which is in the rural southeastern United States
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310158
Entities
People
- Avirup Guha
Organizations
- Augusta University
- United States Army