The effect of androgen deprivation therapy on body composition in men with prostate cancer: systematic review and meta-analysis.
BACKGROUND
The use of androgen deprivation therapy (ADT) in the treatment of prostate cancer is associated with changes in body composition including increased fat and decreased lean mass. Limited information exists regarding the rate and extent of these changes. This systematic review was conducted to determine the effects of ADT on body composition in prostate cancer patients.


METHODS
Literature searches were conducted on MEDLINE, EMBASE and Web of Science for studies until January 2009. Only longitudinal studies that examined ADT and body composition in prostate cancer patients were included. Data were extracted on body weight, BMI, percentage of fat mass and lean body mass.


RESULTS
Sixteen studies (14 cohorts and 2 RCTs) met the inclusion criteria. Pooled data, calculated according to a random effects model, showed that ADT increased % body fat by on average 7.7% (95% CI 4.3, 11.2, from seven studies, P < 0.0001) and decreased % lean body mass by on average -2.8% (95% CI -3.6, -2.0, from six studies, P < 0.0001) but for both there was marked heterogeneity between studies (I2 = 99% I2 = 73%, respectively). Similarly, body weight (2.1%, P < 0.0001 from nine studies) and BMI (2.2%, P < 0.0001, from eight studies) increased significantly. More extensive changes were seen with longer duration of treatment.


CONCLUSIONS
Substantial increases in fat and declines in lean mass were observed in prostate cancer patients treated with ADT. Lifestyle changes or suitable interventions to minimize the effect of ADT on body composition need to be investigated.


CONCLUSIONS
Prostate cancer survivors should be made aware of the side effect of treatment on body composition and further work is required to determine what interventions can minimize the impact of ADT on body composition and therefore what evidence based advice they should be provided with. In general, though recommendation of a healthy diet and moderate exercise is reasonable.
Haseen
Farhana
F
Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK. fhaseen01@qub.ac.uk
Murray
Liam J
LJ
Cardwell
Chris R
CR
O'Sullivan
Joe M
JM
Cantwell
Marie M
MM
D000726:Androgen Antagonists / Q000627:therapeutic use*; D001823:Body Composition; D015992:Body Mass Index; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome
D000726:Androgen Antagonists