The use of exercise interventions to overcome adverse effects of androgen deprivation therapy.
Androgen deprivation therapy (ADT) induces severe hypogonadism and is associated with several adverse effects that negatively affect health and quality of life in patients with prostate cancer. ADT changes body composition characterized by an increase in fat mass and a reduction in muscle mass and strength. Insulin sensitivity is also diminished and population-based studies indicate an increased risk of diabetes mellitus and cardiovascular disease in men receiving ADT. Particularly the first 6 months of treatment seem to hold an additional risk of new cardiovascular events for patients with already existing cardiovascular disease. In this initial phase of ADT, metabolic changes are also most prominent. In addition, ADT increases the rate of bone loss and fracture risk. Currently available evidence supports the use of exercise interventions to improve physical function and mitigate ADT-induced fatigue. Some studies also indicate that exercise might moderate ADT-related changes in body composition. However, beneficial effects of exercise interventions on other ADT-related conditions have not been conclusively proven. Trials investigating the effects of ADT on fracture risk and development of diabetes mellitus and cardiovascular disease are still warranted. Furthermore, studies investigating safety and effects of physical activity in men with bone metastases are lacking.
Department of Urology, Herlev and Gentofte University Hospital Herlev Ringvej 75, 2730 Herlev, Denmark.
Peter Busch
PB
Østergren
Department of Endocrinology, Herlev and Gentofte University Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark.
Caroline
C
Kistorp
Department of Endocrinology, Herlev and Gentofte University Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark.
Finn Noe
FN
Bennedbæk
Department of Endocrinology, Herlev and Gentofte University Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark.
Jens
J
Faber
Department of Urology, Herlev and Gentofte University Hospital Herlev Ringvej 75, 2730 Herlev, Denmark.
Jens
J
Sønksen
Department of Urology, Roskilde University Hospital, Køgevej 7-13, 4000 Roskilde, Denmark.
Mikkel
M
Fode
D000726:Androgen Antagonists / Q000009:adverse effects*; D000818:Animals; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000097:blood / Q000628:therapy; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy; D005081:Exercise Therapy / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D007006:Hypogonadism / Q000097:blood / Q000139:chemically induced / Q000628:therapy*; D008297:Male; D011471:Prostatic Neoplasms / Q000097:blood / Q000628:therapy; D011788:Quality of Life; D016896:Treatment Outcome
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal