Use of β‐blockers is associated with prostate cancer‐specific survival in prostate cancer patients on androgen deprivation therapy

Abstract

BACKGROUND Experimental evidence suggests a role for the β₂‐adrenergic receptor pathway in prostate cancer (PCa). We have investigated the association of β‐blocker use with PCa incidence and survival in a Norwegian cohort. METHODS Data from the Oslo II study in 2000 (n = 6515) were linked with information from the Cancer Registry of Norway and Statistics Norway. PCa risk and overall‐ and PCa‐specific mortality were analyzed using uni‐ and multi‐variable Cox‐ and competing risk regression models. RESULTS At baseline, 776 men (11.9%) reported using a β‐blocker. 212 men (3.3%) were diagnosed with PCa before the survey, leaving 6,303 eligible for incidence analysis. During a median follow‐up of 122 months, 448 (7.1%) men were diagnosed with PCa. β‐blocker use was not associated with PCa risk [hazard ratio (HR): 1.05, 95% CI: 0.79–1.40]. For all patients (n = 655; including med diagnosed before the survey), β‐blocker use was not associated with PCa‐specific mortality (HR: 0.55, 95% CI 0.24–1.26, P = 0.16). However, in the subgroup of men planned to receive androgen deprivation therapy (ADT), as reported to the Cancer Registry (n = 263), β‐blocker use was associated with reduced PCa‐specific mortality (HR: 0.14, 95% CI 0.02–0.85, P = 0.032). No effect on overall mortality was seen (HR, all patients: 0.88, 95% CI 0.56–1.38, P = 0.57). β‐blocker use did not appear to affect PSA level, Gleason score, or T‐stage at diagnosis; however, these variables were missing for many cases. CONCLUSIONS Our findings demonstrate a possible benefit of β‐blocker use for men treated with ADT, suggesting the need for investigation in larger cohorts. Prostate 73: 250–260, 2013.