Effect of exposure to alpha blockers on cancer-specific and overall mortality in men with prostate cancer: a population-based cohort study

Abstract

Background Prostate cancer is the second most common cause of deaths from cancer in men in the UK, accounting for 13% of male cancer mortality in 2010. Conventional treatment results in cure for some patients but does not prevent the metastasis that occurs frequently in others. Radical new therapies are needed to tackle this cancer progression. Alpha blockers are often given for cardiovascular indications and benign prostatic hyperplasia. In mouse models, they reduce angiogenesis and suppress metastasis. This study aimed to determine the eff ect of alpha blockers on mortality outcomes in a population-based cohort of men with prostate cancer. Methods This cohort study used data on 18 654 men with incident prostate cancer from linked UK Clinical Practice Research Datalink, Hospital Episode Statistics, and the National Cancer Intelligence Network between 1998 and 2010. All alpha blocker use in the 6 months after diagnosis of cancer was determined and its eff ect on all-cause and cancerspecifi c mortality assessed. Data were analysed with Cox proportional hazards modelling and adjusted for confounding by age, sex, cancer stage, grade, and important comorbidities and coprescriptions. A sensitivity analysis in patients with an indication of hypertension, interaction by dose, and prediagnosis exposure were also considered.