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News
Sending prostate cancer patients to cardiologists helps their cholesterol — but not their hearts (yet). A large randomized trial found that referring men newly diagnosed with prostate cancer to cardiovascular specialists improved cholesterol control and statin use, but didn't significantly reduce the risk of heart attacks, strokes, or heart failure over nearly six years of follow-up. The jury's still out on whether better risk factor control will eventually translate to fewer cardiac events.
Men with prostate cancer face elevated cardiovascular (CV) risk, especially when on androgen deprivation therapy (ADT) — but does sending them to a cardiologist actually help? A large international randomized trial called RADICAL PC2 set out to answer that question, enrolling over 2,400 men across 8 countries from 2015 to 2025.
Patients referred to an internist or cardiologist were more likely to be prescribed statins, blood pressure medications, and antiplatelets. The intervention group also saw a meaningful drop in total cholesterol — about 12 mg/dL more than the control group. But despite better risk factor control, the referral didn't significantly reduce the composite risk of CV death, heart attack, stroke, or heart failure over a median follow-up of 5.8 years.
Key Takeaways:
Why it matters: This trial highlights an important gap — improving risk factors doesn't always translate to fewer cardiac events, at least not within a 6-year window. For clinicians managing prostate cancer patients on ADT, the findings suggest that targeted referral — especially for those with uncontrolled risk factors — may be the smarter play over universal referral.
