Adverse effects of androgen deprivation therapy: defining the problem and promoting health among men with prostate cancer.
Androgen deprivation therapy (ADT) plays a central role in the management of men with locally advanced, recurrent, and metastatic prostate cancer. Because most men diagnosed with prostate cancer will die of something other than their cancer, treatment-related adverse effects are highly relevant to their long-term health. Benefits of ADT in each clinical setting must be weighed against ADT-related adverse effects. ADT is detrimental to several metabolic end points and to bone health. ADT has been prospectively shown to cause decreased lean muscle mass, increased fat mass, weight gain, increased cholesterol and triglycerides, insulin resistance, and loss of bone mineral density. In population-based analyses it has been associated with an increased incidence of diabetes, clinical fractures, and cardiovascular disease. Data-driven recommendations for managing these adverse effects are needed. Currently the authors advocate the use of adapted practice guidelines developed to prevent diabetes, fractures, and coronary heart disease in the general population.
Saylor
Philip J
PJ
Division of Hematology-Oncology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. psaylor@partners.org
Smith
Matthew R
MR
D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000139:chemically induced; D048909:Diabetes Complications / Q000139:chemically induced; D006293:Health Promotion; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced; D010024:Osteoporosis / Q000139:chemically induced; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D012307:Risk Factors
D000726:Androgen Antagonists