Harvard Heart Letter

Ask the doctor: What can I do to protect my heart if my body no longer makes testosterone?

Q. A year ago, I had an orchiectomy for prostate cancer; my PSA is now 0.74. Not long afterward, I had two cardiac stents implanted. I still have some angina and shortness of breath. I started Ranexa a couple of weeks ago, which helps my angina. Do you have any suggestions for my heart since I no longer make testosterone, which I understand helps protect men's hearts and arteries?

A. In men with prostate cancer, testosterone plays opposing roles. On the negative side of the ledger, it fuels the growth of prostate cancer cells, helping them grow, divide, and sometimes spread throughout the body. For this reason, various methods are used to stop the body from making testosterone or to block cells from responding to it. Removing a man's testicles (orchiectomy) is an effective way to shut off production of this hormone without the need for daily medications. Orchiectomy has been used for years to slow or stop the growth and spread of prostate cancer.

On the positive side of the ledger, testosterone helps maintain muscle mass and healthy cardiac function. In men, low levels of testosterone have been linked to an increased risk for developing type 2 diabetes and cardiovascular disease. And several studies suggest that shutting down or blocking testosterone in men with prostate cancer may increase their risk of developing heart disease.

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