Division of Hematology-Oncology, Massachusetts General Hospital Cancer Center, Massachusetts General Hospital Lawrence House/POB, 55 Fruit Street, Boston, MA 02114, USA.

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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.

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.

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.

Written by:
Saylor PJ, Keating NL, Smith MR.   Are you the author?

Reference:
J Gen Intern Med. 2009 Nov;24 Suppl 2:S389-94.
doi:10.1007/s11606-009-0968-y

PubMed Abstract
PMID:19838837

UroToday.com Prostate Cancer Section

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