'First, do no harm': managing the metabolic impacts of androgen deprivation in men with advanced prostate cancer.
Androgen deprivation therapy (ADT) is a standard systemic treatment for men with prostate cancer. Men on ADT may be elderly and have comorbidities that are exacerbated by ADT, such as cardiovascular disease, diabetes, obesity, sedentary lifestyle and osteoporosis. Studies on managing the impacts of ADT have focused on men with non-metastatic disease, where ADT is given for a limited duration. However, some men with advanced or metastatic prostate cancer will achieve long-term survival with palliative ADT and therefore also risk morbidity from prolonged ADT. Furthermore, ADT is continued during the use of other survival-prolonging therapies for men with advanced disease, and there is a general trend to use ADT earlier in the disease course. As survival improves, management of the metabolic effects of ADT becomes important for maintaining both quality and quantity of life. This review will outline the current data, offer perspectives for management of ADT complications in men with advanced prostate cancer and discuss avenues for further research.
Oncology Unit, Eastern Health, Melbourne, Victoria, Australia.
A J
AJ
Lomax
Oncology Unit, Eastern Health, Melbourne, Victoria, Australia.|Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
P
P
Parente
Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.|Endocrinology Unit, Eastern Health, Melbourne, Victoria, Australia.
C
C
Gilfillan
Faculty of Health, Deakin University, Melbourne, Victoria, Australia.
P M
PM
Livingston
Oncology Unit, Eastern Health, Melbourne, Victoria, Australia.|Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
I D
ID
Davis
Oncology Unit, Eastern Health, Melbourne, Victoria, Australia.|Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
C
C
Pezaro
D000728:Androgens / Q000172:deficiency*; D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology / Q000627:therapeutic use*; D019468:Disease Management; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000188:drug therapy / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism*
D000728:Androgens; D018931:Antineoplastic Agents, Hormonal
advanced prostate cancer; androgen deprivation therapy; metabolic complication; supportive care