Reducing Cardiovascular Risk Associated with ADT in mCSPC

This episode, titled ‘Reducing Cardiovascular Risk Associated with ADT in mCSPC,’ features expert urologists and medical oncologists discussing the following questions:

1. What comorbidities, including cardiovascular risks, are associated with ADT in mCSPC?
2. Why is cardiovascular health an important consideration when initiating ADT therapy in mCSPC?
3. For patients with elevated cardiovascular risk, how can multidisciplinary teams more effectively communicate to properly manage mCSPC in patients on ADTs?

The panelists examine the cardiovascular risks associated with ADT, including weight gain and worsening diabetes, cholesterol, and blood pressure—the “triple header” described by the moderator. Faculty discuss a proactive approach to risk mitigation, including controlling blood pressure before adding an ARPI, prioritizing exercise and resistance training, and coordinating with primary care for monitoring and management of metabolic parameters. The panel also notes growing patient interest in GLP-1 medications for weight management and emphasizes the importance of clinician oversight. Finally, the discussion highlights when to involve cardiology or cardio-oncology, including use of risk tools such as the ASCVD score and practical testing (e.g., labs, EKG, echocardiogram) to facilitate timely referral when access is limited.

In the next episode, ‘Ongoing ADT Monitoring and Treatment Adjustments in Prostate Cancer’, panelists will continue their discussion on advanced prostate cancer and highlight real-world monitoring strategies for patients on ADT, emphasizing cardiometabolic oversight, symptom management, and the value of checking testosterone alongside PSA to detect breakthroughs. They also discuss intermittent therapy as a non-standard but sometimes practical option for selected patients, with oral ADT favored when rapid recovery is important.