Prostate cancer and relation with cardiovascular diseases in hyposexual males

Corresponding author: M.E. Efremov – Сand.Sc.(Med), Assist. of the urology Dept. of the Kuban State Medical University of the Ministry of Health of the Russian Federation; urologist of the Research Institute – Regional Clinical Hospital № 1 Prof. S.V. Ochapovsky, Krasnodar, Russia; e-mail: efremov.uro@yandex.ru

Introduction. In recent decades, cardiovascular diseases (coronary heart disease, arterial hypertension, arrhythmias, dyslipidemia, etc.) and prostate cancer remain quite frequent causes of incidence and mortality. Previously, the results have been obtained, according to which the development of PCa mainly takes place in men, who are characterized by low sexual activity throughout life, in connection with which there is a need to clarify the relationship between the CVD and PCa.

The purpose of the study. Determine the frequency of the diagnosis of CVD in hyposexual men undergoing brachytherapy.

Materials and methods. The study includes 148 men (group I) aged 68 [64; 72] with the first diagnosis of prostate cancer (PCa) T1C-2CN0M0, subject to brachytherapy, and 99 men (II group) at the age of 67 years [62; 72] The diagnosis of prostate hyperplasia (PH).Diagnostics of PCa and PH was carried out in accordance with the current clinical recommendations of RUA and ROUA. All patients independently filled the Rostov questionnaire at an integral assessment of male sexuality [15]. The diagnosis of related cardiovascular diseases and conditions was carried out according to the clinical recommendations of the RCS. The level of general testosterone in the blood serum was determined on the automatic immunochemistiluminated analyzer «Advia CentAur XP» (Siemens).

Results. Almost half of men (50.7%) from the group had a reduced (≤12.0 nmol/l) level of general blood testosterone and low sexuality. In patients with RPGs, angina pectoris, dyslipidemia, extrasystole and bradyarrhythmia (p <0.05) are reliably more common. And patients with PH significantly more often suffer from common atherosclerosis, atherosclerosis of aorta and coronary arteries, chronic heart failure, tachyarrhythmias, obesity, have acute cerebrovascular accident, stenting of coronary arteries/ aorto-coronary noise (p <0.05). As it turned out, there are no differences in the frequency of coronary heart disease, myocardial infarction, diabetes mellitus, hypertension, atherosclerosis of brachiocephalic arteries for PCa and PH. With angina pectoris, the chances of the availability of PCa than the PH, 2.7 times higher compared to the absence of angina pectoris. With dyslipidemia, the chances of the presence of a diagnosis of prource are higher than 3.8 times. With bradyarrhythms and extrasystoles, the chances of the presence of PCa, not PH, are also significantly increased, but the growth intensity is difficult to accurately assess, since there are no data from the CVD in the group of patients with PCa. In chronic heart failure, the chances that the patient has a PH, not PCa, is 2.8 times higher than the lack of chronic heart failure. The presence of the rest of the CVD (percutaneous stenting of coronary arteries/aorto-coronary bypassing and a history of cerebral circulation in the history of cerebral circulation, atherosclerosis, including aorta and coronary arteries, tachyarrhythms) and obesity increases the chances that the patient will have a diagnosis of PH, and not PCa. As for the level of general testosterone of blood, hyposexual men with PCa do not have its reliable effect on the frequency of SVD.

Conclusion. Identification of the frequency of a wide range of CVD for PCa showed a strong relationship for some and low communication for other CVD. Moreover, the comparison of the connection of the CVD with PCa and PH confirms more differences in these connections than similarities. The study of the mechanisms of the communication of CVD with PCa promising in terms of influence on individual factors of a young man in order to reduce the risks of the development of PCa.