Prostate Cancer and Cardiac AFib
Last updated: October 2022
Earlier this year, I was on the upswing. I had finished my radiation and ADT (Eligard) treatments. My PSA was undetectable, and my testosterone was gradually recovering. I seemed to be reclaiming my vigor, and I was doing well at work. I was only vaguely aware of a lurking cardiac danger, but blithely waltzed through life as if I was still an invulnerable 18-year-old.
Suddenly in a panic
That all changed on May 6. I had to run a minor errand on Cape Cod and looked forward to a relaxing half-hour drive to get there. However, fate intervened; the state decided to do some bridge work that day, and I got stuck for 3 hours in traffic under the blazing sun. I was dehydrated, aggravated, and frustrated.
When I finally got home, I was in an agitated state and drank 3-4 glasses of wine on an empty stomach. That certainly relaxed me, but I woke up that night with my heart racing. My pulse jumped up to 120 plus for a few minutes and then back down into the 70s and then back up again. This went on for hours. I was in a panic, and the next day my walk-in clinic told me that I had developed an irregular heartbeat known as atrial fibrillation (AFib).
Why I developed AFib
Why did I develop AFib? Wine drinking (I used to write a wine column in the local paper), blood pressure, and age had a lot to do with it; however, androgen deprivation therapy (ADT) comes with several cardiac risk factors such as weight gain, cholesterol issues, and elevated glucose levels.1 I experienced all these risk factors, but I was not as careful as I should have been. I should also have realized that my age, weight, and blood pressure issues along with ADT put me at risk.
AFib entails a different sort of dread than the one I associate with prostate cancer. Prostate cancer can develop slowly, and I think there is plenty of warning when the end is near. Not so with a cardiac condition; I had the very unpleasant realization that I could drop dead at any moment.
As far as treatment of my AFib, we found a couple of excellent cardiologists and chose a new type of treatment called pulsed field ablation. I would be part of a study for this new type of ablation. After I was anesthetized, incisions would be made in both femoral veins in my groin, and long flexible tubes (catheters) would be snaked up into the heart. From there, short electrical pulses would ablate the heart and correct the AFib.
The procedure went well, but when I woke up from anesthesia, I had a very difficult time, especially with bleeding from my right femoral vein. I will spare you the gruesome details, but it was the worst experience of my life. I was traumatized for days after.
Don't take your health for granted
So the moral is, don’t be naive like me and take your health for granted. Everything is not always alright after ADT; I think it's important to take care of yourself. That could mean considering a change of lifestyle, trying to lose weight, no binge drinking (or no drinking at all). It could also mean exercising.
I think it's good to have doctors carefully monitor your cholesterol, blood pressure, and glucose. Also, when you visit your doctor, I think it's important to be honest about the amount of alcohol you drink.
The good news about AFib is that my past troubles with ADT (Eligard) now seem minor in comparison!
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