Key result
Androgen deprivation therapy is associated with adverse metabolic effects including bone loss, increased fat mass, and decreased insulin sensitivity, leading to greater risks for fractures, diabetes, and cardiovascular disease.
Prostate cancer survivors on ADT face significant metabolic and cardiovascular risks, necessitating routine screening and preventive interventions adapted from general population guidelines.
ADT metabolic risks may warrant monitoring in prostate cancer patients; leaves open optimal interventions pending prospective trials.
BACKGROUND: More than one-third of the estimated 2 million prostate cancer survivors in the United States receive androgen deprivation therapy (ADT). This population of mostly older men is medically vulnerable to a variety of treatment-associated adverse effects. MEASUREMENTS AND RESULTS: Androgen-deprivation therapy (ADT) causes loss of libido, vasomotor flushing, anemia, and fatigue. More recently, ADT has been shown to accelerate bone loss, increase fat mass, increase cholesterol and triglycerides, and decrease insulin sensitivity. Consistent with these adverse metabolic effects, ADT has also recently been associated with greater risks for fractures, diabetes and cardiovascular disease. CONCLUSION: Primary care clinicians and patients should be aware of the potential benefits and harms of ADT. Screening and intervention to prevent treatment-related morbidity should be incorporated into the routine care of prostate cancer survivors. Evidence-based guidelines to prevent fractures, diabetes, and cardiovascular disease in prostate cancer survivors represent an important unmet need. We recommend the adapted use of established practice guidelines designed for the general population.
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Saylor et al. (2009) conducted a review in Prostate Cancer. Androgen Deprivation Therapy was evaluated. Androgen deprivation therapy is associated with adverse metabolic effects including bone loss, increased fat mass, and decreased insulin sensitivity, leading to greater risks for fractures, diabetes, and cardiovascular disease.
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