Androgen deprivation therapy
Cardio-oncological evaluation* in very high and high risk patients**
before cancer treatment
Therapeutic optimization of cardiovascular risk factors and diseases
every 3-6 months
*A cardio-oncological evaluation will systematically include at least one visit with blood pressure, blood glucose, lipid profile, SCORE risk (ESC), GFR calculation, ECG and TTE. Measurements of global longitudinal strain and 3D FeVG (if feasible) are recommended with the same machine.
**Refer to the ESC or ACC/AHA risk categories (previous CV diseases + risk factors).
****In some studies, ACE inhibitors might reduce the overall risk of mortality from prostate cancer.
*****In some studies, statins might lower circulating testosterone levels.
Adapted from Bhatha et al, Circulation. 2016;133:537-541
A: Awareness and Aspirin (if indicated) -Increased awareness of patients of cardiovascular signs and symptoms
B: Blood pressure
Goal blood pressure <140/90 mmHg
C: Cholesterol and Cigarettes
High-intensity statin therapy for preexisting CVD or hyperlipidemia - Smoking cessation counseling, therapy
D: Diet and Diabetes
Diet rich in fruits, vegetables, and whole grain and low in saturated fat with 600 IU vitamin D daily and adequate calcium (1200 mg/d), avoidance of excessive alcohol
150 min/wk of moderate-intensity physical activity or 75 min/wk of vigorous exercise