How do you counsel men with prostate cancer on the cardiovascular risks of androgen deprivation therapy?

This is a complex issue and depends on the specific setting (concurrent with XRT), the risk of the patient, and the specific CV risks of that patient. In the metastatic setting, there is almost never a contraindication to hormonal therapy given that prostate cancer is the likely cause of death in these men. In the adjuvant setting, this issue is much more important. This article in JAMA highlights the issue of comorbidity well in the radiation setting. There are many reviews on this subject. I attach one of them as well as a recent study on intermittent ADT which actually shows more CV risk than continuous therapy! So, this is an evolving area.

Androgen suppression and radiation vs radiation alone for prostate cancer: a randomized trial. (JA...