Ways to look after your heart health when living with prostate cancer

If you’re living with prostate cancer, you may have had many conversations about your prostate health. But have you thought about your heart health? This is an important area of health to consider, particularly if you’re having hormone therapy for your prostate cancer.

Some hormone therapies for prostate cancer have been associated with an increased risk of heart disease.  Androgen deprivation therapy (ADT), a type of hormone therapy for prostate cancer, works by lowering the amounts of male sex hormones, such as testosterone, in the body. But they also have unwanted effects on the health of the heart and vessels that carry blood around the body.

Some potential long-term effects of hormone therapy include: 

• Increased blood sugar levels and reduced ability to process sugar 
  • These effects can cause diabetes, which increases someone’s risk for heart disease or stroke
• Increased cholesterol levels 
  • Cholesterol is important for maintaining the body and making vitamins and hormones, but too much of it can increase risk of heart disease
• Increased body fat
• Reduced muscle mass 
• Increased chance of a heart attack for people that already have atherosclerosis
  • Atherosclerosis is where cholesterol, fatty substances and calcium build up in the arteries and form buildups called plaques

Heart health may also be impacted by the stress of diagnosis. Long-term stress can cause inflammation in the body, which can contribute to issues in the blood vessels that support the heart. If unmanaged, inflammation may lead to problems with the way the heart works. 

Stress may also increase the amounts of certain hormones in the body, which may cause the heart to beat faster and increase blood pressure. Over time, these effects aren’t good for us and can place strain on the heart and blood vessels. 

Looking after your heart health when living with prostate cancer

If you have been diagnosed with prostate cancer, heart health is a priority. This is true for people with and without an existing heart problem. 

If you don’t have a known heart condition and are starting, or already on, hormone therapy 

Some things that increase someone’s chance of heart problems can’t be changed. These include age, ethnicity, or having a family history of heart disease. But some lifestyle factors can be changed. Through being aware of your increased risk for heart disease and taking small protective steps, you may lower your risk of developing heart disease.

• Diet 

  Eating healthily can help you look after your heart health. You may be able to control your blood pressure through limiting your salt intake, as well as sugar and saturated fat, and eating plenty of fruits, vegetables and whole grains. This is known as the DASH diet, which stands for Dietary Approaches to Stop Hypertension. 

  When thinking about heart health, it’s also important to aim for a diet low in cholesterol – so limiting intake of fried foods, fast foods, processed foods, and certain desserts.

• Physical activity 

  Exercise has many beneficial effects. It may lower blood pressure and help you manage your weight. Not getting enough exercise or physical activity may increase your chance of heart disease. 

  The American Heart Association recommends at least:

  • 150 minutes of moderate-intensity exercise per person per week – this is exercise that makes you breathe faster but doesn’t leave you out of breath, such as brisk walking, cycling or swimming at a relaxed pace, or mowing the lawn   
  • 75 minutes of vigorous exercise – this is exercise that makes your breathing deeper and more rapid, such as running, swimming laps, or certain types of dance
  • At least 2x sessions of muscle strengthening activity – this may involve using resistance bands or weights to work the muscles, or you can use body weight, such as when doing lunges or squats 

  Ideally activity is spread out through the week and involves a combination of moderate intensity and vigorous exercises. Even just spending less time sitting down can be beneficial for health. 

  Learn more about some exercises you can do in the comfort of your own home.  Remember to speak with your doctor before trying any new exercises.

• Weight management 

  Generally, being overweight is classed as a body mass index (also known as BMI) score of over 25. Your BMI number is calculated through your ratio of height to weight, and it estimates the amount of body fat you have.  

  Often, the higher someone’s BMI is, the higher their risk for some health conditions, including heart disease. But it’s worth noting there are limitations to the BMI calculation, so always discuss your results with your doctor to better understand what your BMI means for you. 

  If you’re looking to reduce your BMI, then diet and exercise may be two areas of focus. The general rule of thumb is to ensure you are using more energy (calories) through exercise than you’re taking in from your diet, in order to lose weight. But everyone’s situation is different so make sure you speak with your care team before starting any new diet or exercise plan.

• Avoid smoking and tobacco products 

  Not smoking is one of the most important ways to lower your chance of heart disease, heart attack and strokes. If you are already smoking, deciding to quit can be tough – but there are small steps you can take to help.

  If you don’t smoke, try and limit your exposure to second-hand smoke (this is smoke from other people smoking). Keep your distance from people that are smoking and make indoor spaces as smoke-free as possible – either through asking people not to smoke in your spaces or opening windows and doors to let smoke out of shared spaces.

If you already have a certain health condition and are starting, or already taking, hormone therapy 

Having hormone therapy for prostate cancer when living with a known heart problem or diabetes may put you at a higher risk of a cardiac event. If you’ve been diagnosed with any of the conditions listed below, then it’s important to speak with your doctor about how hormone therapy may further impact your health. These include:

• Coronary artery disease, which is where blood vessels that supply the heart can’t deliver enough oxygen-rich blood to the heart muscle
• Atherosclerosis, which is where a build-up of substance in the blood vessels causes them to narrow and become harder
• Having experienced a heart attack in the past
• Having high blood pressure
• Having high cholesterol
• Having diabetes 

Many of the heart health tips recommended above for people without existing heart disease are also recommended for people with a known heart problem. These include following a healthy diet, doing exercise, maintaining a healthy weight, and avoiding smoking. It’s also important to continue taking any medication you are on as prescribed – unless told otherwise by your doctor.

Keeping on top of your stress levels is important for heart health, particularly if living with a known health condition. You may achieve this with support from your care team or through making lifestyle changes. Some people find relaxation techniques such as meditation and yoga helpful for managing their stress. 

When living with prostate cancer, it’s important to have good partnership and communication with your health team. Be sure to talk to them about all elements of your health and how to take care of yourself. Don’t hesitate to reach out to them if you notice any new, unusual, or worsening symptoms. 

We hope you find these tips for managing heart health helpful. Remember, it’s important to speak with your care team before starting any new diet, exercise or intervention for your heart health. They will be able to let you know what’s suitable for your individual situation.