Does surgery or radiotherapy carry an increased risk of cardiovascular disease and bone fractures (independent of ADT)?

ADT increases the risk of cardiovascular disease, but what about surgery and radiotherapy themselves; do they increase the risk of cardiovascular? This paper is a retrospective analysis from information on over 60,000 men. All the patients were over 65 years of age, but had clinically localized disease (i.e., has not spread outside the prostate).

Radiotherapy by itself was found to carry a slightly elevated risk of coronary heart disease, sudden cardiac death, fractures and fractures requiring hospitalization.

Wallis CJ, Mahar AL, Satkunasivam R, Herschorn S, Kodama RT, Lee Y, Kulkarni GS, Narod SA, Nam RK. 2016. Cardiovascular and skeletal-related events following localized prostate cancer treatment: role of surgery, radiotherapy, and androgen deprivation. Urology 97(2016):145-152.